范秀丽长春九台区中医院骨科，吉林长春　130500

2型糖尿病并髋部骨折高龄患者骨代谢研究

范秀丽
长春九台区中医院骨科，吉林长春130500

目的 探讨2型糖尿病并髋部骨折高龄患者骨代谢的改变情况，并了解其机制，进一步探析2型糖尿病与髋部骨折间的关系。方法 选择3组患者作为研究对象，分别为2型糖尿病并髋部骨折高龄患者（A组）、单纯2型糖尿病患者（B组）、健康者（C组）。每组78例。测定3组患者甲状旁腺素（PTH）、血清骨钙素（BGP）、降钙素（CT）、骨密度（BMD），3组进行比较。结果 高龄2型糖尿病并髋部骨折患者与单纯糖尿病者比较，骨代谢各指标及骨密度，差异无统计学意义（P＞0.05），但二者与健康者比较，BGP、CT、BMD均较低（P＜0.05），PTH则较高（P＜0.05）。结论 高龄2型糖尿病患者非常容易出现骨质疏松症，骨吸收有所增加但骨形成降低，高龄2型糖尿病患者的骨质量改变与髋部骨折无直接关系。

2型糖尿病；骨密度；髋部骨折

DOI：10.16658/j.cnki.1672-4062.2016.10.005

［Abstract］Objective To discuss the changes of bone metabolism of elderly patients with type 2 diabetes combined with hip fracture and understand its mechanism thus further discussing and analyzing the correlation between type 2 diabetes and hip fracture.Methods The group A（elderly patients with type 2 diabetes combined with hip fracture）,group B（patients with simple type 2 diabetes）and group C（healthy persons）were selected as the research objects with 78 cases in each,the parathyroid hormone,bone gla-containing protein,calcitonin and bone mineral density of the three groups were measured and compared.Results The differences in the various indexes of bone metabolism and bone mineral density between the elderly patients with type 2 diabetes combined with hip fracture and the patients with simple diabetes were not obvious without statistical significance（P＞0.05）,however,the BGP,CT and BMD of the two were lower than those of healthy persons（P＜0.05）,but the PTH was higher（P＜0.05）.Conclusion The elderly patients with type 2diabetes are extremely prone to suffer osteoporosis,the bone resorption increases but the bone formation decreases,and the changes of bone quality of elderly patients with type 2 diabetes have no direct correlation with the hip fracture.

［Key words］Type 2 diabetes；Bone mineral density；Hip fracture

糖尿病在临床比较常见，属于一种慢性全身性内分泌代谢疾病，会出现脂肪、蛋白质及糖代谢紊乱，同时还会引发骨代谢紊乱，会造成不同程度上的骨量减少，严重可至骨质疏松［1］。一旦发生骨折疏松，患者发生骨折的风险性就增加，因为骨折疏松特征是骨强度下降，高龄患者一旦出现骨质疏松，就容易发生髋部骨折。笔者对高龄2型糖尿病并髋部骨折患者的骨代谢指标及骨密度进行测定，与单纯糖尿病者及健康者比较，旨在探析其骨代谢的改变，为临床防治提供依据，现报道如下。

1　资料与方法

1.1一般资料