CAJ | 학술논문

目的：了解中度慢性阻塞性肺疾病（COPD）患者吸入沙美特罗替卡松对骨代谢的影响及其与吸入时间长短的关系。方法60例COPD患者按照随机数字表法分为试验组和对照组，各30例。对照组每日进行常规治疗，不使用任何形式的糖皮质激素。试验组吸入沙美特罗替卡松，每日2次，每次1吸，连续用药12个月，其余治疗同对照组。采用双能X线骨密度仪（DXA）在治疗前、治疗3个月、治疗12个月分别测定2组患者股骨三角的骨密度（BMD），同时用酶联免疫吸附试验测定血骨钙素（BGP）和碱性磷酸酶（ALP）。结果2组患者治疗前和治疗3个月后，BMD、BGP、ALP比较差异无统计学意义（P＞0.05）。治疗12个月后，试验组BMD低于对照组，BGP和ALP高于对照组，差异有统计学意义（P＜0.05）。试验组治疗3个月与治疗前BMD、BGP、ALP比较差异无统计学意义，治疗12个月比治疗前BMD降低，治疗12个月比治疗前ALP和BGP增加，差异有统计学意义（P＜0.05）。对照组治疗前后BMD、ALP、BGP比较差异无统计学意义。结论沙美特罗替卡松短期吸入对老年COPD患者的骨密度无不良影响，但长期吸入会导致COPD患者骨密度下降。
목적：료해중도만성조새성폐질병（COPD）환자흡입사미특라체잡송대골대사적영향급기여흡입시간장단적관계。방법60례COPD환자안조수궤수자표법분위시험조화대조조，각30례。대조조매일진행상규치료，불사용임하형식적당피질격소。시험조흡입사미특라체잡송，매일2차，매차1흡，련속용약12개월，기여치료동대조조。채용쌍능X선골밀도의（DXA）재치료전、치료3개월、치료12개월분별측정2조환자고골삼각적골밀도（BMD），동시용매련면역흡부시험측정혈골개소（BGP）화감성린산매（ALP）。결과2조환자치료전화치료3개월후，BMD、BGP、ALP비교차이무통계학의의（P＞0.05）。치료12개월후，시험조BMD저우대조조，BGP화ALP고우대조조，차이유통계학의의（P＜0.05）。시험조치료3개월여치료전BMD、BGP、ALP비교차이무통계학의의，치료12개월비치료전BMD강저，치료12개월비치료전ALP화BGP증가，차이유통계학의의（P＜0.05）。대조조치료전후BMD、ALP、BGP비교차이무통계학의의。결론사미특라체잡송단기흡입대노년COPD환자적골밀도무불량영향，단장기흡입회도치COPD환자골밀도하강。
Objective To observe the effects of salmeterol/fluticasone on the bone metabolism and bone density of the patients with moderate COPD and whether the effects is relate with inhaled corticosteroid course. Methods Sixty pa-tients with COPD were divided into 2 groups by random digit table. Patients in experimental group (n=30) were given conven-tional therapy with salmeterol/fluticasone one inhale(bid) for continuously 12 months while patients in control group (N=30) were given conventional therapy without any glucocorticoid.The bone mineral density (BMD) of the femoral triangle in all patients were measured by DXA before therapy, 3 months and 12 months after therapy. At the same time, biochemical indi-cators that are correlated with bone metabolism include bone gla protein (BGP) and alkaline phosphatase (ALP) were mea-sured by radioimmunoassay. Results The BMD, BGP and ALP of patients in experimental group and in control group be-fore therapy, 3 month and 12 month after therapy were compared. There is no significant difference (P>0.05) between these two groups before therapy and after 3 month but significant difference was shown after 9 months (P<0.05). Conclusion Short period inhaling salmeterol/fluticasone in patients with COPD is safe. But long-term inhaling salmeterol/fluticason may lead to decline of the bone density in patients with COPD.