中度慢性阻塞性肺疾病患者吸入沙美特罗替卡松对骨代谢的影响

发布时间：2018-11-22 15:20

【摘要】：目的了解中度慢性阻塞性肺疾病(COPD)患者吸入沙美特罗替卡松对骨代谢的影响及其与吸入时间长短的关系。方法 60例COPD患者按照随机数字表法分为试验组和对照组,各30例。对照组每日进行常规治疗,不使用任何形式的糖皮质激素。试验组吸入沙美特罗替卡松,每日2次,每次1吸,连续用药12个月,其余治疗同对照组。采用双能X线骨密度仪(DXA)在治疗前、治疗3个月、治疗12个月分别测定2组患者股骨三角的骨密度(BMD),同时用酶联免疫吸附试验测定血骨钙素(BGP)和碱性磷酸酶(ALP)。结果 2组患者治疗前和治疗3个月后,BMD、BGP、ALP比较差异无统计学意义(P0.05)。治疗12个月后,试验组BMD低于对照组,BGP和ALP高于对照组,差异有统计学意义(P0.05)。试验组治疗3个月与治疗前BMD、BGP、ALP比较差异无统计学意义,治疗12个月比治疗前BMD降低,治疗12个月比治疗前ALP和BGP增加,差异有统计学意义(P0.05)。对照组治疗前后BMD、ALP、BGP比较差异无统计学意义。结论沙美特罗替卡松短期吸入对老年COPD患者的骨密度无不良影响,但长期吸入会导致COPD患者骨密度下降。
[Abstract]:Objective to investigate the effect of salmeterol on bone metabolism in patients with moderate chronic obstructive pulmonary disease (COPD) and its relationship with duration of inhalation. Methods 60 patients with COPD were randomly divided into experimental group and control group, 30 cases in each group. The control group received daily routine treatment without any form of glucocorticoid. The experimental group inhaled salmeterolticasone twice a day once a time for 12 months and the rest were treated with the control group. Bone mineral density (BMD),) of femoral triangle was measured by dual energy X-ray absorptiometry (DXA) after 3 months and 12 months of treatment before treatment. Simultaneous determination of osteocalcin (BGP) and alkaline phosphatase (ALP). By enzyme linked immunosorbent assay Results there was no significant difference in BMD,BGP,ALP between the two groups before treatment and 3 months after treatment (P0.05). After 12 months of treatment, the BMD of the experimental group was lower than that of the control group, and the BGP and ALP were higher than that of the control group (P0.05). There was no significant difference in BMD,BGP,ALP between the experimental group and the treatment group after 3 months treatment. The BMD decreased at 12 months compared with that before treatment, and the ALP and BGP increased after 12 months treatment (P0.05). There was no significant difference in BMD,ALP,BGP before and after treatment in the control group. Conclusion the short-term inhalation of salmeterolticasone has no adverse effect on BMD in elderly patients with COPD, but long-term inhalation may lead to the decrease of BMD in COPD patients.
【作者单位】：天津医科大学第二医院呼吸科;
【分类号】：R563.9

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