Evaluate The Clinical Application Of Chronic Obstructive Pulmonary Disease In Male Merger Osteoporosis By Dual-energy X-ray Absorptiometry

Objective:By studying the BMD(Bone mineral density) of male patients with chronic obstructive pulmonary disease(COPD) and those male COPD patients with consolidated pulmonary heart disease(pulmonary heart disease), also the indicators such as Blood gas analysis(PaO2、PaCO2), lung function(FEV1 %pred、FEV1 /FVC), Body mass index(BMI) and so on of these patients, to discuss the relationship bettween male COPD patients,male COPD patients with pulmonary heart disease and osteoporosis(OP).Methods :Selected 31 patients with COPD, of which there were 17 cases who had a long history of smoking, while the other 14 cases were non-smokers; Besides,selected another group of 20 COPD patients with pulmonary heart disease, of which 18 cases had a long history of smoking and 2 cases were non-smokers. The 51 patients mentioned were all male. Selected 31 age-matched healthy male volunteers in the control group(no smoking history). Then used Dual-energy X-ray absorptiometry instrument(DXA) to measure the bone mineral density(BMD) of each group lumbar(L1-4) and proximal femur, also detected lung function(FEV1% pred, FEV1 / FVC),arterial blood gas(PaO2, PaCO2) and serum calcium(Ca) concentration, serum alkaline phosphatase(ALP) concentration in the experimental group.Results1, Compared with the healthy control group, the age, serum calcium(Ca)concentration and serum alkaline phosphates’(ALP) concentration of the COPD group had no statistically significant difference(P> 0.05); However, the BMD of COPD group was significantly lower than that of the healthy group, the difference was statistically significant(P <0.01), of which the patients’ bone mineral density that had a history of smoking had reduced much more significantly, the difference was statistically significant(P <0.05).2, The smoking rate of COPD with pulmonary heart disease was higher than that of COPD group, the difference was statistically significant(P <0.01).3, The BMD of L1 vertebra and femoral neck(Neck) of the COPD with pulmonary heart disease group decreased significantly than that of the COPD group,the difference was significant(P <0.05).4, The BMD had a positive linear correlation with FEV1% pred, FEV1 / FVC,PaO2, body mass index(BMI) in COPD group.5, The receiver operating characteristic curve(ROC curve) analysis showed that the ROC curve area which the bone mineral density predicted the pulmonary heart disease was bettween 0.5 to 0.65.That is to say,the BMD values cound not predict the tendencies of COPD patients to have secondary pulmonary heart disease.Conclusion:1 、 The bone mineral density of male patients pure with COPD significantly lowered than that of normal peers,2、Smoking not only increased degree of osteoporosis in patients with COPD,but also might be a risk factor in patients with COPD to induce pulmonary heart disease.3、The osteoporosis of male COPD patients were closely related to their degree of lung function, PaO2, body mass index(BMI).4、The bone density values would be further reduced in male COPD patients with pulmonary heart disease.5、 BMD cound not yet be a predictor of the tendency of male COPD patients to have pulmonary heart disease.