慢性阻塞性肺疾病与骨质疏松

摘要

慢性阻塞性肺疾病( chronic obstructive pulmonary disease,COPD)为进行性不完全可逆的气流受限,伴有一些显著的肺外效应,其中包括骨质疏松等疾病,COPD致骨质疏松的发病机制不是很明确,可能与吸烟、低氧、运动减少、使用糖皮质激素等因素有关. 吸烟是COPD的重要发病因素,也是骨质疏松的危险因素,COPD患者体力和耐力下降,运动量不足,骨丢失增多,低氧血症和高碳酸血症引起破骨细胞活性增强,抑制骨形成,在COPD患者中糖皮质激素的应用使得患者骨强度下降,低体重与骨密度密切相关,营养不良可减少营养吸收,炎症因子在骨质疏松中也扮演了重要作用.%Chronic obstructive pulmonary disease ( COPD) is not completely reversible airflow limited, with some significant extrapulmonary effects, including osteoporosis.The pathogenesis of COPD-induced osteoporosis is not very clear.It may be associated with smoking, low oxygen, reduced movement, use of corticosteroids, and other factors.Smoking is an important risk factor of COPD, and it is also a risk factor for osteoporosis.Physical strength and endurance exercise in COPD patients are insufficient, leading to increase of bone loss.Hypoxemia and hypercapnia cause increase of osteoclast activity and inhibition of bone formation.The application of glucocorticoids in patients with COPD results in bone strength decline.Low weight is closely related to bone mineral density and poor nutrition can reduce nutrient absorption.Inflammatory factors also play an important role in osteoporosis.