CAJ | 학술논문

目的：研究老年人骨质疏松与颈动脉粥样硬化的相关性，给出颈动脉内中膜厚度（ IMT）、粥样斑块直径与骨密度T值之间联系。方法研究对象为第二人民医院老年科门诊和住院患者100例，采用双能X线吸收法（DXA）测定腰椎骨和股骨区的骨密度（BMD）；同时采用彩超探查颈总及颈内动脉IMT 及粥样斑块的情况。根据颈动脉病变程度分为3组：A组（无病变组）、B组（轻度病变组）和C组（中重度病变组）。结果C组甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、骨碱性磷酸酶（BALP）水平明显低于A组，总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）明显高于A组，差异均有统计学意义（P＜0.05）。 B组BALP水平明显低于A组，差异有统计学意义（P＜0.05）。 C组BALP水平明显低于B组，差异有统计学意义（P＜0.05）。 C组第2-4腰椎及股骨颈BMD水平均明显低于A组，C组股骨颈 BMD水平明显低于B组，B组股骨颈 BMD水平亦明显低于A组，差异均有统计学意义（P＜0.01）。结论老年颈动脉粥样硬化病变程度严重者，骨密度较正常及轻度者偏低。对有颈动脉粥样硬化的老年人随访及体检时加强骨密度检测可能有积极意义。
목적：연구노년인골질소송여경동맥죽양경화적상관성，급출경동맥내중막후도（ IMT）、죽양반괴직경여골밀도T치지간련계。방법연구대상위제이인민의원노년과문진화주원환자100례，채용쌍능X선흡수법（DXA）측정요추골화고골구적골밀도（BMD）；동시채용채초탐사경총급경내동맥IMT 급죽양반괴적정황。근거경동맥병변정도분위3조：A조（무병변조）、B조（경도병변조）화C조（중중도병변조）。결과C조감유삼지（TG）、고밀도지단백담고순（HDL-C）、골감성린산매（BALP）수평명현저우A조，총담고순（TC）、저밀도지단백담고순（LDL-C）명현고우A조，차이균유통계학의의（P＜0.05）。 B조BALP수평명현저우A조，차이유통계학의의（P＜0.05）。 C조BALP수평명현저우B조，차이유통계학의의（P＜0.05）。 C조제2-4요추급고골경BMD수평균명현저우A조，C조고골경 BMD수평명현저우B조，B조고골경 BMD수평역명현저우A조，차이균유통계학의의（P＜0.01）。결론노년경동맥죽양경화병변정도엄중자，골밀도교정상급경도자편저。대유경동맥죽양경화적노년인수방급체검시가강골밀도검측가능유적겁의의。
Objective To investigate the correlation between osteoporosis and carotid atherosclerosis in the elderly, and to find out the relationship among the carotid artery intima-media thickness (IMT), the diameter of atherosclerotic plaque, and the T-value of the bone mineral density (BMD).Methods One hundred senile patients from the Out-patient and In-patient Department of Geriatrics in the Second People’ s Hospital were selected.BMD of the lumbar vertebrae and the femur was detected using dual energy X-ray absorptiometry (DXA).At the same time, color Doppler ultrasound was applied to detect the IMT of the common carotid artery and the internal carotid artery.The condition of atherosclerotic plaque was also detected.According to the degree of carotid artery lesions, patients were divided into 3 groups:Group A (no-lesion group), Group B (minor lesion group), and Group C (moderate lesion group).Results The serum levels of TG, HDL-C, and BALP in Group C were significantly lower than those in Group A, while the levels of TC and LDL-C were significantly higher than that in Group A (P<0.05).The serum level of BALP in Group B was significantly lower than that in Group A ( P <0.05).And the serum level of BALP in Group C was significantly lower than that in Group B (P<0.05).BMD of the lumbar vertebrae (L2-4 ) and the femoral neck in Group C was significantly lower than that in Group A, and BMD of the femoral neck in Group C was significantly lower than that in Group B, while BMD of the femoral neck in Group B was significantly lower than that in Group A (P<0.01).Conclusion The elderly patients with severe carotid atherosclerosis have a lower BMD, compared with the patients with no-lesions or minor lesions. Enhanced BMD detection during the follow-up and physical examination of the elderly patients with carotid atherosclerosis may have positive significance.