高血压患者用血管紧张素转换酶抑制剂治疗时的骨密度  

Bone mineral density in hypertensive patients under treatment with Bone mineral density in hypertensive patients under treatment with angiotensin converting enzyme inhibitor

作　　者：阎德文[1] 王建平[1] 吴清平[1] 王月菊[1] 

机构地区：[1]深圳市红十字会医院内分泌科,518029

出　　处：《中国骨质疏松杂志》1999年第4期30-32,13,共4页Chinese Journal of Osteoporosis

摘　　要：目的　探讨血管紧张素转换酶抑制剂（ＡＣＥＩ）对人体中轴骨骨量的影响。方法　我们将１２８ 例绝经后妇女分为４ 组：Ａ 组：正常血压组４６ 例；Ｂ组：高血压ＡＣＥＩ短程（＜ ５ 年，中位数为３ 年）治疗组１８ 例；Ｃ组：高血压ＡＣＥＩ长程（≥５ 年，中位数７．５ 年）治疗组３０ 例；Ｄ 组：高血压心痛定治疗组３４ 例。采用双能 Ｘ 线吸收法测量其腰椎正侧位（ＡＰＬ２－４、ＬａｔＬ２－４）和左股骨近端各区（包括Ｎｅｃｋ、Ｔｒｏｃｈ、Ｉｎｔｅｒ、Ｔｏｔａｌ和Ｗ ａｒｄｓ）的骨密度，并检测了部分患者血清ＢＧＰ和晨尿羟脯氨酸（Ｈｏｐ／Ｃｒ）等生化指标。结果　Ｂ组和Ｃ组ＡＰＬ２－４骨密度分别明显高于Ｄ 组；Ｂ组和Ｃ组股骨近端除Ｔｒｏｃｈ 外其他各区骨密度均分别明显高于Ｄ组，且Ｃ组尚显著高于Ａ 组，有显著差异（Ｐ＜ ０．０５）；同Ａ 组和Ｄ 组相比，Ｂ组和Ｃ组Ｔｒｏｃｈ 和ＬａｔＬ２－４骨密度亦有增加趋势。此外，Ｃ组骨密度比Ｂ组有增高趋势，但差异无显著意义。Ｂ组和Ｃ组血清ＢＧＰ和晨尿ＨＯＰ水平分别明显低于Ａ 组或Ｄ 组（Ｐ＜ ０．０５），但Ｂ、Ｃ二组间无显著差异；各组间血清钙、磷、ＡＬＰ水平无显著差异。结论　ＡＣＥＩ对骨量具有一定的保持作用，特别?Objective\ To evaluate the effect of angiotensin converting enzyme inhibitor (ACEI),anti hypertensive drugs,on human axial bone mass. Methods One hundred twenty eight postmenopausal women,aged 56.0±5.9yrs,were divided into 4 groups:normotensive group(A,N=46);ACEI treated hypertensive group (B,N=18),the course of treatment <5yrs ,median 3yrs;ACEI treated hypertensive group(C,N=30),the course of treatment >5yrs,median 7.5yrs ;and nifedipine treated hypertensive group(D,N=34).The bone mineral density(BMD) was measured by dual energy X ray absorptiometry at their lumbar vertebrae(AP L2 4 ,Lat L2 4 )and proximal femur(including Neck,Troch,Inter,Total,Wards).The blood and urine samples were collected for determination of biochemical indices,such as serum bone Gla protein(BGP)and ratio of fasting urinary hydroxyproline to creatinine(Hop/Cr),in part of them. Results BMD at AP L2 4 and proximal femur (excluding Troch) in groups B and C were significantly higher than that in group D.BMD at proximal femur (excluding Troch) in group C was also significantly higher than that in group A( P<0.05 ).BMD at Troch and Lat L2 4 in groups B and C showed a tendency to increase,compared to group A or D.BMD at all sites in group C also showed a tendency to increase,compared to group B,but the difference between the group B and the group C was not significant ( P>0.05 ).The concentration of BGP and fasting urinary Hop/Cr in groups B and C were lower than those in group A or D,but there was no significant difference between group B and group C.The levels of serum ALP,calcium and phosphate had no significant differance among the 4 groups. Conclusion ACEI can preserve bone mass,and be used for postmenopausal,especially hypertensive, women.

关 键 词：骨密度 ACEI 治疗组 高血压患者 股骨近端 晨尿 血管紧张素转换酶抑制剂 骨量 血清 APL 

分 类 号：R681[医药卫生—骨科学] R544.1[医药卫生—外科学]