维生素K2联合咪达普利对合并高血压的老年女性骨质疏松患者的疗效观察  

Observation of the effect of vitamin K2 combined with imidapril on elderly female osteoporosis patients with hypertension

作　　者：徐凤周 范金鹏 高开茜 安少波 刘永强 XU Fengzhou;FAN Jinpeng;GAO Kaiqian;AN Shaobo;LIU Yongqiang(Fourth Orthopedic Ward, Shijiazhuang People’s Hospital, Shijiazhuang 050000, China;Fourth Ward of Cardiology, Shijiazhuang People’s Hospital, Shijiazhuang 050000,China;Department of Internal Medicine, Shijiazhuang Fifth Hospital, Shijiazhuang 050000, China)

机构地区：[1]石家庄市人民医院骨科四病区,河北石家庄050000 [2]石家庄市人民医院心内四科,河北石家庄050000 [3]石家庄市第五医院综合内科,河北石家庄050000

出　　处：《中国骨质疏松杂志》2021年第2期269-274,共6页Chinese Journal of Osteoporosis

基　　金：河北省石家庄市科学技术局项目(161462393)。

摘　　要：目的研究合并高血压病的老年女性骨质疏松患者口服维生素K2联合咪达普利对骨密度(bone mineral density,BMD)、骨代谢、新发骨折率及不良反应的影响。方法选择2018年7月至2019年8月石家庄市第一医院收治的合并高血压的老年女性骨质疏松患者40例为研究对象,随机分为观察组、对照组,各20例,对照组服用咪达普利,观察组在此基础上加服四烯甲萘醌软胶囊。6个月后,观察两组患者新发骨折率、不良反应率,测定血清骨代谢指标和腰及髋部BMD的水平。结果治疗6个月后,与治疗前相比两组25(OH)D3增加、PTH下降(P<0.05),两组OC、BAP及各处BMD升高,TRACP-5b、s-CTX降低(P<0.001);与对照组相比,观察组BAP、OC更高,TRACP-5b、s-CTX更低,经校正P<0.001;与对照组相比,观察组腰椎、股骨颈BMD较高(P<0.05),△BMD差异有统计学意义(P<0.001);协方差校正股骨粗隆BMD及△BMD两组间比较差异有统计学意义(P<0.05);观察组治疗前BMD同治疗后BMD水平呈线性相关(P<0.001),BMD水平治疗前、后回归线斜率(b)不同。新发骨折率及不良反应率组间对比差异无统计学意义(P>0.05)。结论①维生素K2及咪达普利对合并高血压的老年女性骨质疏松患者联合用药效果有叠加作用,对骨代谢及骨密度有更好的改善作用;②联合用药对身体各处骨密度改善水平并不一致,骨密度基线水平可能对骨密度改善的曲线存在影响。Objective To study the effect of oral vitamin K2 combined with imidapril on bone mineral density,bone metabolism,new fracture rate and adverse reactions in elderly female osteoporosis patients with hypertension.Methods From July 2018 to August 2019,40 elderly female osteoporosis patients with hypertension in our hospital were selected as the research objects,and they were randomly divided into an observation group and a control group,20 cases each group,the control group took imidapril,and the observation group added vitamin K2 soft capsules on this basis.After 6 months,the new fracture rate and adverse reaction rate of the two groups of patients were observed,and the serum bone metabolism index level and the BMD level of the waist and hip were measured.Results After 6 months of treatment:Compared with before treatment,25(OH)D3 increased and PTH decreased(P<0.05),OC,BAP and BMD increased in both groups,TRACP-5b and s-CTX decreased P<0.001;Compared with before treatment,25(OH)D3 increased and PTH decreased(P<0.05),OC,BAP,and BMD increased in both groups,and TRACP-5b and s-CTX decreased(P<0.001).Compared with the control group,the observation group had higher BAP and OC and lower TRACP-5b and s-CTX,corrected(P<0.001);Compared with the control group,the BMD of the lumbar spine and femoral neck was higher in the observation group(P<0.05),and the difference in△BMD was statistically significant(P<0.001);the covariance corrected for the femoral tuberosity BMD and△BMD between the two groups Statistical significance(P<0.05);The BMD level of the observation group before treatment was linearly correlated with the BMD level after treatment(P<0.001),and the slope of the regression line(b)before and after treatment was different.There was no statistically significant difference between the new fracture rate and the adverse reaction rate between the groups(P>0.05).Conclusion①Vitamin K2 and imidapril have a superimposed effect on the combined medication of elderly female patients with osteoporosis with hypertension,and hav

关 键 词：骨质疏松 高血压 咪达普利 维生素K2 

分 类 号：R68[医药卫生—骨科学]