阿仑膦酸钠联合阿托伐他汀钙片治疗老年性骨质疏松症的疗效和安全性评价  

Evaluation of the curative efficacy and safety of alendronate sodium combined with atorvastatin calcium in the treatment of senile osteoporosis

作　　者：卓孟川[1] 王振林[1] 刘康[2] 孙青青[3] 

机构地区：[1]解放军第一一三医院骨科,浙江宁波315040 [2]浙江中医药大学附属第二医院骨科,浙江杭州310005 [3]解放军第一一三医院眼科,浙江宁波315040

出　　处：《中国现代医生》2017年第2期60-63,共4页China Modern Doctor

基　　金：浙江省教育厅一般科研项目(Y201121321)

摘　　要：目的研究阿仑膦酸钠联合阿托伐他汀钙片治疗老年性骨质疏松症的临床疗效并对其安全性进行评价。方法将2013年10月~2015年12月期间我院收治的150例老年骨质疏松症患者根据随机数字表法随机分成研究组(n=75)和对照组(n=75)。其中对照组患者口服阿仑膦酸钠和阿法骨化醇治疗,研究组在对照组的基础上加用阿托他汀钙片治疗,治疗时间均为24周共1个疗程。比较两组患者的临床疗效、疼痛VAS评分、骨密度(BMD)以及相关血清学指标,同时分析评估两组患者出现的不良反应情况。结果治疗后研究组疗效(94.67%)明显高于对照组(72.00%),差异有统计学意义(χ~2=13.87,P=0.00)。治疗后两组患者的疼痛VAS评分均明显下降,且研究组患者疼痛VAS评分明显低于对照组(P<0.05)。治疗后两组患者股骨、腰椎(L_(2~4))、Ward三角区、股骨颈、股骨粗隆的BMD较治疗前均明显升高,且研究组股骨、腰椎(L_(2~4))、股骨颈处的BMD明显高于对照组(P<0.05)。治疗后两组患者的血清骨钙素(BGP)和骨源性碱性磷酸酶(BAP)均明显升高,Ⅰ型胶原氨基末端肽(NTx)和Ⅰ型胶原羧基末端肽(CTx)明显降低,且研究组患者血清中NTx和CTx明显低于对照组(P<0.05)。两组患者治疗期间不良反应发生率无明显差异(χ~2=0.46,P=0.50)。结论阿仑膦酸钠联合阿托伐他汀钙片治疗老年性骨质疏松症的临床疗效显著,且安全性高,临床应用前景广阔。Objective To investigate the clinical efficacy of alendronate sodium combined with atorvastatin calcium in the treatment of senile osteoporosis and to perform the safety evaluation for the treatment. Methods A total of 150 el- derly patients with osteoporosis who were admitted to our hospital from October 2013 to December 2015 were randomly divided into the study group（n=75） and the control group（n=75） according to the method of random number table. Pa- tients in the control group were orally given alendronate sodium and alfacalcidol, and the study group was further given atmvastatin calcium on the basis of the control group. The treatment time was 24 weeks for a total of 1 course of treat- ment. The clinieal efficacy, pain VAS score, bone mineral density（BMD） and related serological parameters were com- pared between the two groups. At the same .time, the adverse reactions of the two groups were analyzed and evaluated. Results The curative effect in the study group （94.67%） was significantly higher than that in the control group （72.00%）, and the difference was statistically significant（X^2=13.87, P=0.00）. After the treatment, the pain VAS scores of the two groups were significantly decreased. The pain VAS score in the study group was significantly lower than that in the control group（P〈0.05）. BMD of femur, lumbar vertebrae（L2-4）, Ward triangle zone, femoral neck and femoral trochanter was increased significantly after treatment in both groups compared with that before the treatment, and BMD of femur, lumbar vertebrae（L2-4） and femoral neck in the study group was significantly higher than that in the control group（P〈 0.05）. After the treatment, serum bone gla protein （BGP） and bone alkaline phosphatase（BAP） were significantly increased in both groups. Type I NTx and type I CTx were significantly decreased, and serum NTx and CTx in the study group were significantly lower than those in the control group（P〈O.05）. There was no significant difference between

关 键 词：阿仑膦酸钠 阿托伐他汀 骨质疏松症 不良反应 

分 类 号：R714.257[医药卫生—妇产科学] R969.4[医药卫生—临床医学]