Lehouck A, van Remoortel H, Troosters T, Decramer M, Janssens W
Service de Pneumologie, Hôpital Universitaire Gasthuisberg, Katholieke Universiteit, 3000 Leuven, Belgique.
Rev Mal Respir. 2010 Dec;27(10):1231-42. doi: 10.1016/j.rmr.2010.10.007. Epub 2010 Oct 30.
Increasing evidence indicates that COPD and osteoporosis are strongly linked. Both diseases share common risk factors like age, smoking and inactivity but the typical presence in COPD of systemic inflammation, vitamin D deficiency and the frequent use of corticosteroids catalyse ongoing bone resorption. Osteoporosis in its turn may lead to vertebral compression fractures with a consequent further decline of forced vital capacity and forced expiratory volume in one second. In addition, fragility fractures in disabled COPD patients may cause further immobility and increased morbidity. Prevention and treatment of osteoporosis in COPD should therefore be based on population specific risk assessments which combine measures of bone mineral density and clinical factors. Unfortunately, intervention studies specifically designed for patients with COPD are currently lacking and no specific guidelines have yet been established. Hence, a rigorous application of the current treatment guidelines with respect to osteoporosis in general would already be a major step forward in the treatment of COPD.
越来越多的证据表明，慢性阻塞性肺疾病（COPD）与骨质疏松症密切相关。这两种疾病有共同的风险因素，如年龄、吸烟和缺乏运动，但COPD中典型存在的全身炎症、维生素D缺乏以及频繁使用皮质类固醇会促使骨吸收持续进行。反过来，骨质疏松症可能导致椎体压缩性骨折，从而使用力肺活量和一秒用力呼气量进一步下降。此外，残疾COPD患者的脆性骨折可能导致进一步的活动受限和发病率增加。因此，COPD患者骨质疏松症的预防和治疗应基于针对特定人群的风险评估，该评估结合了骨密度测量和临床因素。不幸的是，目前缺乏专门为COPD患者设计的干预研究，也尚未制定具体指南。因此，严格应用目前关于骨质疏松症的一般治疗指南，在COPD治疗方面已经是向前迈出的重要一步。
