Kochetkova E A, Ugaĭ L G, Nevzorova V A, Massard J
Ter Arkh. 2013;85(3):28-31.
To evaluate the functional state of bone tissue in patients with idiopathic pulmonary fibrosis (IPF), waiting for lung transplantation, and to determine possible predictors of lower bone mineral density (BMD) in this pathology in the pretransplantation period.
Forty-nine IPF patients waiting for lung transplantation were examined. The patients' mean age was 53.4 +/- 6.4 years. BMD in the lumbar spine (L(II)-L(IV)) and femoral neck (FN) was estimated using dual-energy X-ray absorptiometry. All the patients underwent external respiratory function test, pulmonary diffusing capacity (DL(CO)), gasometry, and 6-minute walk test (6'WT).
Osteopenia was recorded in 77% of the examinees, of them 28% had osteoporosis (OP). Normal BMD in both L(II)-L(IV) and FN was found only in 13% of the patients. The T score in L(II)-L(IV) was directly related to body mass index. There was a direct correlation between BMD in L(II)-L(IV) and FN, forced vital capacity (FVC), DL(CO), and arterial blood oxygen saturation (SaO2) and an inverse correlation with arterial carbon dioxide partial pressure (pCO2). No significant correlation was found between the distance covered in 6'WT, FEV1, pO2, and BMD in both L(II)-L(IV) and FN. Six (15%) subjects had atraumatic fractures at different sites.
Osteopenia is a common systemic manifestation in patients with IPF in the pre-transplantation period. BMI, FVC, exercise desaturation, and DL(CO) may be considered as predictors for the development of OP initiated by IPF.
评估等待肺移植的特发性肺纤维化（IPF）患者骨组织的功能状态，并确定该病理状态下移植前期骨密度（BMD）降低的可能预测因素。
对49例等待肺移植的IPF患者进行检查。患者平均年龄为53.4±6.4岁。采用双能X线吸收法评估腰椎（L(II)-L(IV)）和股骨颈（FN）的骨密度。所有患者均接受肺通气功能检查、肺弥散功能（DL(CO)）、血气分析及6分钟步行试验（6'WT）。
77%的受检者存在骨量减少，其中28%患有骨质疏松症（OP）。仅13%的患者L(II)-L(IV)和FN的骨密度正常。L(II)-L(IV)的T值与体重指数直接相关。L(II)-L(IV)和FN的骨密度与用力肺活量（FVC）、DL(CO)及动脉血氧饱和度（SaO2）呈正相关，与动脉血二氧化碳分压（pCO2）呈负相关。6'WT行走距离、第一秒用力呼气容积（FEV1）、动脉血氧分压（pO2）与L(II)-L(IV)和FN的骨密度之间未发现显著相关性。6例（15%）受试者在不同部位发生了非创伤性骨折。
骨量减少是IPF患者移植前期常见的全身表现。体重指数、用力肺活量、运动性低氧血症和肺弥散功能可被视为IPF引发骨质疏松症的预测因素。
