pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2016-26-3-336-339pulmo-724Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESЛегочная гиперинфляция и риск переломов у больных хронической обструктивной болезнью легкихLung hyperinflation and the risk of fractures in patients with chronic obstructive pulmonary diseaseКочетоваЕ. В.KochetovaE. V.

к. м. н., доцент кафедры госпитальной терапии ФГБОУ ВПО «Петрозаводский государственный университет»; тел.: (8142) 764445

PhD, Associate Professor at Department of Hospital Internal Medicine, Petrozavodsk State University; tel.: (8142) 764445

67011@mail.ruФГБОУ ВПО «Петрозаводский государственный университет»: 185910, Россия, Республика Карелия, Петрозаводск, просп. Ленина, 33РоссияPetrozavodsk State University: 33, Lenina av., Petrozavodsk, Republic of Karelia, RussiaRussian Federation201627072016263336339Copyright © Кочетова Е.В., 20162016Кочетова Е.В.Kochetova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/724

Целью исследования явилось изучение у больных хронической обструктивной болезнью легких (ХОБЛ) легочной гиперинфляции (ЛГ) и риска переломов с помощью компьютерной программы FRAX.

Материалы и методы

Материалы и методы. Обследованы пациенты с ХОБЛ (n = 125: мужчины с длительным стажем курения; индекс курильщика – 240, стаж курения – 40 пачко-лет). Оценка 10"летнего риска остеопоротических переломов проводилась с помощью компьютерной программы FRAX. Исследование функции внешнего дыхания проводилось на многомодульной установке MasterLab (Erich Jaeger, Германия).

Результаты

Результаты. Показатели ЛГ возрастали по мере усугубления стадии ХОБЛ. Максимальный уровень общей емкости легких (ОЕЛ) наблюдался у пациентов с ХОБЛ IV стадии – 131,43 ± 38,99 %. При III стадии ХОБЛ ОЕЛ составляла 126,68 ± 21,58 %, при II стадии – 115,39 ± 23,68 %. ОЕЛ достоверно возрастала с ухудшением стадии ХОБЛ (р < 0,05). В группе лиц с уровнем остаточного объема легких (ООЛ) < 200 %долж. высокий риск (> 3) перелома шейки бедра выявлен у 24,24 % больных, с уровнем ООЛ > 200 %долж. – у 45,71 %.

Заключение

Заключение. Показатели ЛГ и высокий риск переломов были максимальными у больных IV стадии ХОБЛ.

The purpose of this study was to investigate an association between lung hyperinflation and the risk of bone fracture in patients with chronic obstructive pulmonary disease (COPD).

Methods

Methods. The study involved 125 smokers with COPD. The patients treated with systemic steroids were excluded from the study. Lung function and bone mineral density were measured in all the patients. The risk of osteoporotic bone fractures was calculated by FRAX tool.

Results

Results. Lung hyperinflation increased according to the COPD stage. The highest total lung capacity (TLC) was observed in patients with 4 stage COPD (131.43 ± 38.99%pred.) followed by 126.68 ± 21.58%pred. in 3 stage COPD and 115.39 ± 23.68%pred. in 2 stage COPD (p < 0.05). The highest risk of hip fracture (> 3) was calculated for 24.24% of patients with residual lung volume (RV) < 200%pred. and for 45.71% of patients with RV > 200%pred. 

Conclusions

Conclusions. The risk of hip fracture was significantly associated with the severity of hyperinflation in COPD patients. The highest risk of fractures was found in patients with 4 stage COPD.

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The authors declare that there are no conflicts of interest present.