依那普利和替米沙坦对绝经后原发性高血压女性患者骨密度及骨转化的影响  

Effects of Enalapril and Telmisartan on Bone Density and Bone Turnover in Postmenopausal Women with Primary Hypertension

作　　者：李霞绯[1] 吴娟[1] 

机构地区：[1]重庆市第三人民医院老年病科,重庆400014

出　　处：《中国药房》2013年第48期4534-4536,共3页China Pharmacy

基　　金：重庆市卫生局科研资助项目(No.2012-2-216)

摘　　要：目的:观察依那普利和替米沙坦对绝经后原发性高血压女性患者骨密度及骨转化指标的影响。方法:将120例绝经后原发性高血压患者随机分为血管紧张素转换酶抑制剂组(ACEI组)、血管紧张素Ⅱ受体阻滞药组(ARB组)和钙通道阻滞药组(CCB组),每组各40例患者,分别给予依那普利、替米沙坦和硝苯地平进行降压治疗。治疗1年后,观察3组患者血压、骨密度(BMD)、骨钙素、β胶原特殊序列(β-CTX)及血清钙离子和磷离子浓度的变化。结果:治疗前3组患者各项指标比较,差异均无统计学意义。治疗后,3组患者血压均降至正常范围,且血清钙离子和磷离子浓度及骨钙素组间比较差异无统计学意义。ACEI组患者β-CTX较治疗前显著下降(P<0.05),BMD显著升高(P<0.05),而骨钙素无显著变化(P>0.05);ARB组和CCB组患者的BMD显著下降(P<0.05),而骨钙素及β-CTX无显著变化(P>0.05);组间比较,ACEI组患者β-CTX显著低于ARB组和CCB组患者,BMD显著高于ARB组和CCB组患者,差异均有统计学意义(P<0.05)。3组患者血清钙离子、磷离子的浓度治疗前、后均无显著变化(P>0.05)。结论:依那普利具有抑制骨吸收的作用,能改善绝经后高血压女性患者骨量的丢失,而替米沙坦不具备此作用。OBJECTIVE： To observe the effects of enalapril and telmisartan on bone density and index of bone turnover in postmenopausal women with primary hypertension. METHODS： 120 postmenopausal women with primary hypertension were ranomly divided into ACEI group, ARB group and CCB group with 40 patients in each group. They were given enalapril, telmisartan and nifedipine, respectively. These parameters of 3 groups were measured after a year, such as blood pressure, BMD, osteocalcin, β-Crosslaps （β-CTX） , blood calcium, blood phosphorus. RESULTS： There was no statistical significance in the difference of above index among 3 groups before treatment. After treatment, the blood pressure of 3 groups reduced and rettLrned to normal level. Before treatment, β-CTX of ACEI group was decreased significantly after treatment （P〈0.05）, while BMD was increased significantly （P〈0.05）. There was no significant change in osteocalcin, blood calcium and blood phosphorus （P〉0.05）. BMD of ARB group and CCB group were decreased significantly （P〈0.05）, while osteocalcin and β-CTX had no significant change （P〉0.05）. β-CTX of ACEI group was significantly lower than that of ARB group and CCB group; BMD of ACEI group was significantly higher than that of ARB group and CCB group; there was statistical significance （P〈0.05）. The concentrations of calcium ion and phosphonium ion in serum bad no significant change among 3 groups （P〉 0.05）. CONCLUSIONS： Enalapril have potentially beneficial effects on bone health in postmenopausal women with hypertension by inhibiting bone resorption, while telmisartan dosen＇t.

关 键 词：依那普利 替米沙坦 骨密度 β胶原特殊序列 骨钙素 

分 类 号：R453.9[医药卫生—治疗学]