唑来膦酸治疗COPD患者骨质疏松症的疗效及对肺功能影响的分析

摘要

Objective To evaluate the efficacy of zoledronic acid on osteoporosis in COPD patients and its influence in the pulmonary function. Methods Fifty-two COPD patients with osteoporosis were treated with zoledronic acid for 1 year. Bone mineral density (BMD) of the lumbar spine and the hip, pulmonary function, serum levels of Ca, P, BGP, BALP, Dpd/Cr, and VAS score were determined before and after the treatment. Results After 1-year treatment, the pain symptom relieved, FEV1 and FEV1 ％ increased significantly, and BMD of lumbar vertebrae and femoral neck increased. △FEV1, the change value of FEV1 and FEVl before and after the treatment, was positively correlated with BMD of the lumbar vertebrae. BGP increased significantly, ALP and Dpd/Cr decreased significantly after the treatment, and the serum levels of Ca and P had no change. Conclusion Zoledronic acid improves bone metabolism and BMD, and improves pulmonary function. It can be used in the treatment of osteoporosis in COPD patients.%目的 研究COPD患者骨质疏松症经唑来膦酸治疗的疗效及对肺功能影响.方法 COPD合并骨质疏松患者52例, 给予唑来膦酸及基础药物治疗, 疗程1年, 测量治疗前后腰椎、髋部骨密度 (BMD) 、肺功能及血清中血钙、血磷、骨特异性碱性膦酸酶 (BALP), 血清骨钙素 (BGP) 和晨尿游离脱氧吡啶啉排泄率 (Dpd/Cr) 、VAS及活动能力评分.结果 治疗1年后疼痛症状改善, FEV1、FEV1％有显著提高, 腰椎、股骨颈BMD升高, 差异有统计学意义.治疗前FEV1、治疗后FEVl变化值△FEV1与腰椎骨密度变化值正相关.治疗后BGP值升高, ALP、Dpd/Cr值均下降, 而血磷、血钙均无变化.结论 唑来膦酸可以增加骨密度, 改善骨代谢, 同时改善通气功能, 可以应用在COPD骨质疏松症的治疗.