骨质疏松与器官异位钙化偏相关分析

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摘要目的了解住院老年人骨质疏松与器官异位钙化的相关性。方法选取2013年3月~2016年9月在解放军第一八一医院住院的322例老年患者。记录性别、年龄、体重指数、骨密度取股骨或腰椎两个部位的低值，其中，骨量正常组88例，骨量减少组96例，骨质疏松组138例。采用美国生产的DPX-NT双能X骨密度仪，测量部位为L2~L4、双侧股骨颈、粗隆及Wards三角区，用CT或X线片或彩超检查头颅、脊柱、膝关节、肺部、双侧颈动脉、腹主动脉、下肢动脉、肝、胆、肾等。按低龄老年人、高龄老年人及全部老年人、男性、女性的骨密度与上述器官有无钙化进行偏相关分析。结果骨量正常组、骨量减少组、骨质疏松组三组比较：腹主动脉钙化、腰椎压缩性骨折、膝关节退行性变成增生差异有高度统计学意义（P ＜ 0.01）。两两比较显示，腹主动脉钙化、膝关节退变或增生，骨质疏松组比骨量减少组及骨量正常组严重（P ＜ 0.05）；腰椎压缩性骨折，骨量减少组和骨质疏松组较骨量正常组多发，差异有高度统计学意义（P ＜ 0.01）。各组胆道结石比较差异无统计学意义（P > 0.05）。按年龄进行偏相关分析：各组患者的骨密度与腰椎骨折相关，全部病例组及高龄老年人组的骨密度与腹主动脉钙化、膝关节退行性变或增生及胆道结石相关（P ＜ 0.05）。颈动脉、腹主动脉、下肢动脉钙化，与年轻老年人比较，高龄老年人组均较明显（P ＜ 0.01），脊柱退行性变和骨质增生、膝关节退行性变和骨质增生高龄老年人组多见（P ＜ 0.05），泌尿系结石、胆道结石也以高龄老年人组多发，差异有统计学意义（P ＜ 0.05）。按性别进行偏相关分析：男性骨密度均与腹主动脉钙化、膝关节退行性变或增生、胆道结石相关（P ＜ 0.05）。女性骨密度与肾脏钙化和胆道结石相关（P ＜ 0.05）。结论骨密度与腹主动脉钙化、腰椎压缩性骨折、肾脏钙化、膝关节退行性变或增生及胆道结石相关。

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	刘学员1 喻智2 熊义博1▲ 邓泽熙1 卢水焕1 赵蕾1 何杰1 唐慧明

关键词 ：骨质疏松, 异位钙化, 骨密度, 偏相关分析, 老年人

Abstract：Objective To investigate the relationship between osteoporosis and ectopic calcification in elderly inpatients. Methods Three hundred and twenty-two cases of elderly patients hospitalized in the 181st Hospital of PLA from March 2013 to September 2016 were selected. Gender, age and body mass index (BMI) were recorded. Bone mineral density (BMD) was measured in two sites of femur and lumbar spine. There were 88 patients of normal bone mass, 96 cases of osteopenia, 138 cases of osteoporosis. Bone mineral density of site L2-L4, bilateral femoral neck, trochanter and Wards triangle were measured by the DPX–NT dual-energy X-ray bone mineral density produced in America. Head, spine, knee joint, the lungs, bilateral carotid arteries, abdominal aorta, lower limb artery, liver, gallbladder, kidney were checked with CT, X-rays or color ultrasonic. BMD and calcification of the above organs were analyzed by partial correlation among the elderly, male and female groups. Results Compared in normal bone, osteopenia and osteoporosis groups: the differences of abdominal aortic calcification, lumbar compression fracture, knee joint degeneration or proliferation were statistically significant (P < 0.01). Compared with each other: the differences of abdominal aortic calcification, knee joint degeneration or proliferation were significantly severer in osteoporosis group than those in bone mass reduction group and bone normal group (P < 0.05); the lumbar compression fracture in bone mass reduction group or osteoporosis group was more common than that of normal group, the difference was statistically significant (P < 0.01). There was no difference in gallstone among all groups (P > 0.05). Partial correlation analysis according to ages: BMD was associated with lumbar fracture in all groups. BMD in all patients and elderly group were associated with abdominal aortic calcification, knee joint degeneration or hyperplasia and gallstone (P < 0.05). Calcification in carotid artery, abdominal aorta, lower extremity arterial, compared with the younger age group, the older age group were more obvious and the differences were statistically significant (P < 0.01); spinal degenerative changes and bone hyperplasia, knee joint degeneration, bone hyperplasia, urinary stone and gallstone were prevalent in older elderly group, the differences were statistically significant (P ＜ 0.05). Partial correlation analysis with gender: BMD was associated with abdominal aortic calcification, knee joint degeneration or hyperplasia and bile gallstone in male (P < 0.05). BMD was associated with kidney calcification, gallstone in female (P < 0.05). Conclusion BMD is associated with abdominal aortic calcification, lumbar compression fracture, renal calcification, knee joint degeneration, hyperplasia and gallstone.

Key words： Osteoporosis Ectopiccalcification Bone mineral density Partial correlation Elderly

基金资助:军队保健专项科研课题（12BJZ14）；
广西壮族自治区桂林市科学研究与技术开发计划项目（2016012702-6）。

通讯作者: ▲通讯作者

作者简介: 刘学员（1964.5-），男，主任医师，硕士生导师，主要从事内分泌等老年慢性病研究。

引用本文:

刘学员1 喻智2 熊义博1▲ 邓泽熙1 卢水焕1 赵蕾1 何杰1 唐慧明. 骨质疏松与器官异位钙化偏相关分析[J]. 中国医药导报, 2018, 15(20): 100-104.
LIU Xueyuan1 YU Zhi2 XIONG Yibo1▲ DENG Zexi1 LU Shuihuan1 ZHAO Lei1 HE Jie1 TANG Huiming1. Partial correlation analysis between osteoporosis and ectopic calcification. 中国医药导报, 2018, 15(20): 100-104.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I20/100

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