阿仑膦酸钠联合阿托伐他汀对糖尿病合并骨质疏松患者骨密度及骨代谢指标的影响
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摘要
目的:探讨阿仑膦酸钠联合阿托伐他汀对糖尿病合并骨质疏松患者骨密度及骨代谢指标的影响。方法:选取2016年3月-2018年3月本院收治的糖尿病合并骨质疏松40例,应用随机数字表法将患者分为对照组和研究组,各20例。对照组使用阿仑膦酸钠治疗,研究组使用阿仑膦酸钠联合阿托伐他汀治疗。比较两组患者股骨粗隆、腰椎正位、股骨颈、前臂骨密度、血清谷钙素、血磷、血钙含量、骨源性碱性磷酸酶、骨钙素N端中分子、骨保护素含量以及腹胀、恶心、腹痛等不良反应。结果:研究组股骨粗隆、腰椎正位、股骨颈、前臂骨密度均高于对照组(P<0.05);研究组血清谷钙素含量高于对照组(P<0.05);研究组血磷、血钙含量与对照组比较,差异均无统计学意义(P>0.05);研究组骨源性碱性磷酸酶、骨钙素N端中分子、骨保护素含量均高于对照组(P<0.05);研究组腹胀、恶心、腹痛不良反应发生率低于对照组(P<0.05)。结论:治疗糖尿病合并骨质疏松期间,将阿仑膦酸钠与阿托伐他汀联合疗效更佳,值得在临床上应用与推广。
Objective:To investigate the effect of Alendronate Sodium combined with Atorvastatin on bone mineral density and bone metabolism in diabetic patients with osteoporosis.Method:40 patients with diabetes mellitus and osteoporosis admitted from March 2016 to March 2018 were selected,and they were divided into control group and study group,according to the random number table method,20 cases in each group.The control group was treated with Alendronate Sodium,and the study group was treated with Alendronate Sodium combined with Atorvastatin.The adverse reactions of femoral trochanter,lumbar spine alignment,femoral neck,forearm bone density,serum glutenin,blood phosphorus,blood calcium content,osteogenic alkaline phosphatase,molecules at the N end of osteocalcin,osteoprotetin content,abdominal distention,nausea,abdominal pain and so on were compared between the two groups.Result:The BMD of femoral trochanter,lumbar spine,femoral neck and forearm in the study group were higher than those in the control group(P<0.05).Serum glutenin content in the study group was higher than that in the control group(P<0.05).There were no significant differences in the content of blood phosphorus and calcium between the study group and the control group(P>0.05).The contents of osteogenic alkaline phosphatase,osteocalcin N terminal molecules and osteoprotetin in the study group were higher than those in the control group(P<0.05).The incidence of adverse reactions of abdominal distension,nausea and pain in the study group was lower than that in the control group(P<0.05).Conclusion:During the treatment of diabetes mellitus with osteoporosis,the combination of Alendronate Sodium and Atorvastatin has a better curative effect,which is worthy of clinical application and promotion.
Objective:To investigate the effect of Alendronate Sodium combined with Atorvastatin on bone mineral density and bone metabolism in diabetic patients with osteoporosis.Method:40 patients with diabetes mellitus and osteoporosis admitted from March 2016 to March 2018 were selected,and they were divided into control group and study group,according to the random number table method,20 cases in each group.The control group was treated with Alendronate Sodium,and the study group was treated with Alendronate Sodium combined with Atorvastatin.The adverse reactions of femoral trochanter,lumbar spine alignment,femoral neck,forearm bone density,serum glutenin,blood phosphorus,blood calcium content,osteogenic alkaline phosphatase,molecules at the N end of osteocalcin,osteoprotetin content,abdominal distention,nausea,abdominal pain and so on were compared between the two groups.Result:The BMD of femoral trochanter,lumbar spine,femoral neck and forearm in the study group were higher than those in the control group(P<0.05).Serum glutenin content in the study group was higher than that in the control group(P<0.05).There were no significant differences in the content of blood phosphorus and calcium between the study group and the control group(P>0.05).The contents of osteogenic alkaline phosphatase,osteocalcin N terminal molecules and osteoprotetin in the study group were higher than those in the control group(P<0.05).The incidence of adverse reactions of abdominal distension,nausea and pain in the study group was lower than that in the control group(P<0.05).Conclusion:During the treatment of diabetes mellitus with osteoporosis,the combination of Alendronate Sodium and Atorvastatin has a better curative effect,which is worthy of clinical application and promotion.
引文
[1]雷雷,郑瑞芝,王月霞,等.阿托伐他汀联合阿仑膦酸钠治疗老年性骨质疏松的临床疗效及安全性[J].中国骨质疏松杂志,2016,22(8):1031-1034.
[2]王玮琪,茹选良,刘春,等.阿托伐他汀联合阿仑膦酸钠治疗老年性骨质疏松的临床疗效及安全性评价[J].中国临床药理学杂志,2016,5(4):312-314.
[3]黎宗保.激素替代疗法联合阿仑膦酸钠治疗对绝经后骨质疏松症患者子宫内膜及骨代谢的影响[J].山东医药,2016,56(25):90-92.
[4] Listed N.Retraction:Paper“Comparison of Effects of Alendronate and Raloxifene on Lumbar Bone Mineral Density,Bone Turnover,and Lipid Metabolism in Elderly Women with Osteoporosis” by Iwamoto J,et al.[Yonsei Med J 2008;49(1):119-128][J].Yonsei Medical Journal,2018,59(1):167.
[5]徐蓉,丘凌,汪思阳,等.外源性胰岛素在老年2型糖尿病患者骨质疏松治疗中的作用[J].中国骨质疏松杂志,2017,23(8):1002-1006.
[6]王朝旭,邓飞,吴丹.阿仑膦酸钠对甲状腺功能减患者骨密度及骨生化、代谢影响的临床研究[J].中国骨质疏松杂志,2018,24(1):44-47.
[7]陈国仙,王国荣,李国山,等.低强度复合振动联合阿仑膦酸钠对绝经后骨质疏松患者骨密度的影响研究[J].中国康复医学杂志,2017,32(2):182-186.
[8] Akhverdyan Y,Zavodovsky B,Polyakova J,et al.AB0405Effects of Atorvastatin on Dynamics of Bone Mineral Density in Patients with Rheumatoid Arthritis[J].Annals of the Rheumatic Diseases,2016,75(Suppl 2):1044-1045.
[9]尹立,钟凤林,刘绍江,等.阿托伐他汀联合阿司匹林对绝经期冠心病妇女骨密度及骨生化和代谢的影响[J].中国骨质疏松杂志,2017,23(9):1149-1152.
[10]梅坚,王静,李芹,等.唑来膦酸对系统性红斑狼疮合并骨质疏松患者骨密度及骨代谢的影响[J].中国药房,2017,28(2):197-200.
[11]覃裕,邱冰,朱思刚,等.唑来膦酸与阿仑膦酸钠治疗骨质疏松患者的疗效比较及对血清25-(OH)D、BALP、BGP的影响分析[J].中国骨质疏松杂志,2016,22(8):1035-1038.
[12] Shahrezaee M,Oryan A,Bastami F,et al.Comparative impact of systemic delivery of atorvastatin,simvastatin,and lovastatin on bone mineral density of the ovariectomized rats[J].Endocrine,2018,60(1):1-13.
[13]陈可,燕宪亮.葛根素注射液治疗老年女性骨质疏松症合并不稳定型心绞痛的疗效分析[J].中国药房,2017,28(12):1644-1647.
[14]丁建红,于莹,王淑红,等.鲑鱼降钙素对社区糖尿病合并骨质疏松患者骨密度的影响[J].中国老年学,2016,36(17):4222-4223.
[15]吴静,陈玲,白玉晓,等.不同骨量状态的2型糖尿病患者骨密度影响因素分析[J].中国骨质疏松杂志,2016,22(10):1283-1287.
[16] Yano T,Yamada M,Inoue D.Effect of Sequential Treatment with Bisphosphonates After Teriparatide in Ovariectomized Rats:A Direct Comparison Between Risedronate and Alendronate[J].Calcified Tissue International,2017,101(1):102-110.
[17]陈磊,赵纯冰,张智慧,等.辛伐他汀联合依那普利对老年高血压患者骨质疏松治疗的效果观察[J].中国骨质疏松杂志,2017,23(10):1292-1295.
[18]蔡攀,陆燕,娄玉健,等.金天格胶囊对老年高血压患者骨密度、骨代谢及骨硬化蛋白水平的影响[J].中国骨质疏松杂志,2017,23(12):1621-1624.
[19] Oliveira L C,Oliveira R G,Piresoliveira D A A.Effects of whole body vibration on bone mineral density in postmenopausal women:a systematic review and meta-analysis[J].Osteoporos Int,2016,27(10):2913-2933.
[20]邓训训,林伟文.阿托伐他汀联合阿仑膦酸钠治疗高龄骨质疏松的疗效及其对OPG和骨代谢指标的影响[J].中国医学创新,2016,13(18):22-26.
[2]王玮琪,茹选良,刘春,等.阿托伐他汀联合阿仑膦酸钠治疗老年性骨质疏松的临床疗效及安全性评价[J].中国临床药理学杂志,2016,5(4):312-314.
[3]黎宗保.激素替代疗法联合阿仑膦酸钠治疗对绝经后骨质疏松症患者子宫内膜及骨代谢的影响[J].山东医药,2016,56(25):90-92.
[4] Listed N.Retraction:Paper“Comparison of Effects of Alendronate and Raloxifene on Lumbar Bone Mineral Density,Bone Turnover,and Lipid Metabolism in Elderly Women with Osteoporosis” by Iwamoto J,et al.[Yonsei Med J 2008;49(1):119-128][J].Yonsei Medical Journal,2018,59(1):167.
[5]徐蓉,丘凌,汪思阳,等.外源性胰岛素在老年2型糖尿病患者骨质疏松治疗中的作用[J].中国骨质疏松杂志,2017,23(8):1002-1006.
[6]王朝旭,邓飞,吴丹.阿仑膦酸钠对甲状腺功能减患者骨密度及骨生化、代谢影响的临床研究[J].中国骨质疏松杂志,2018,24(1):44-47.
[7]陈国仙,王国荣,李国山,等.低强度复合振动联合阿仑膦酸钠对绝经后骨质疏松患者骨密度的影响研究[J].中国康复医学杂志,2017,32(2):182-186.
[8] Akhverdyan Y,Zavodovsky B,Polyakova J,et al.AB0405Effects of Atorvastatin on Dynamics of Bone Mineral Density in Patients with Rheumatoid Arthritis[J].Annals of the Rheumatic Diseases,2016,75(Suppl 2):1044-1045.
[9]尹立,钟凤林,刘绍江,等.阿托伐他汀联合阿司匹林对绝经期冠心病妇女骨密度及骨生化和代谢的影响[J].中国骨质疏松杂志,2017,23(9):1149-1152.
[10]梅坚,王静,李芹,等.唑来膦酸对系统性红斑狼疮合并骨质疏松患者骨密度及骨代谢的影响[J].中国药房,2017,28(2):197-200.
[11]覃裕,邱冰,朱思刚,等.唑来膦酸与阿仑膦酸钠治疗骨质疏松患者的疗效比较及对血清25-(OH)D、BALP、BGP的影响分析[J].中国骨质疏松杂志,2016,22(8):1035-1038.
[12] Shahrezaee M,Oryan A,Bastami F,et al.Comparative impact of systemic delivery of atorvastatin,simvastatin,and lovastatin on bone mineral density of the ovariectomized rats[J].Endocrine,2018,60(1):1-13.
[13]陈可,燕宪亮.葛根素注射液治疗老年女性骨质疏松症合并不稳定型心绞痛的疗效分析[J].中国药房,2017,28(12):1644-1647.
[14]丁建红,于莹,王淑红,等.鲑鱼降钙素对社区糖尿病合并骨质疏松患者骨密度的影响[J].中国老年学,2016,36(17):4222-4223.
[15]吴静,陈玲,白玉晓,等.不同骨量状态的2型糖尿病患者骨密度影响因素分析[J].中国骨质疏松杂志,2016,22(10):1283-1287.
[16] Yano T,Yamada M,Inoue D.Effect of Sequential Treatment with Bisphosphonates After Teriparatide in Ovariectomized Rats:A Direct Comparison Between Risedronate and Alendronate[J].Calcified Tissue International,2017,101(1):102-110.
[17]陈磊,赵纯冰,张智慧,等.辛伐他汀联合依那普利对老年高血压患者骨质疏松治疗的效果观察[J].中国骨质疏松杂志,2017,23(10):1292-1295.
[18]蔡攀,陆燕,娄玉健,等.金天格胶囊对老年高血压患者骨密度、骨代谢及骨硬化蛋白水平的影响[J].中国骨质疏松杂志,2017,23(12):1621-1624.
[19] Oliveira L C,Oliveira R G,Piresoliveira D A A.Effects of whole body vibration on bone mineral density in postmenopausal women:a systematic review and meta-analysis[J].Osteoporos Int,2016,27(10):2913-2933.
[20]邓训训,林伟文.阿托伐他汀联合阿仑膦酸钠治疗高龄骨质疏松的疗效及其对OPG和骨代谢指标的影响[J].中国医学创新,2016,13(18):22-26.