探讨锝(99 Tc)亚甲基二磷酸盐治疗2型糖尿病合并骨质疏松对心血管的影响  

To Explore the Effect of Technetium(99 Tc)Methylene Bisphosphate in the Treatment of Type 2 Diabetes Mellitus with Osteoporosis on Cardiovascular

作　　者：宾小昌 温玉洁[1] 胡欣[1] 陈小舟 黄鑫[1] 唐金凤 莫子韶[1] Bin Xiaochang;Wen Yujie;Hu Xin(Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin,Guangxi 541002,China)

机构地区：[1]广西壮族自治区南溪山医院,广西桂林541002

出　　处：《四川医学》2021年第2期175-180,共6页Sichuan Medical Journal

基　　金：广西壮族自治区南溪山医院科研课题腾飞计划(编号:20170011)。

摘　　要：目的探讨锝(99 Tc)亚甲基二磷酸盐治疗2型糖尿病(T2DM)合并骨质疏松对心血管的影响。方法选取2017年7月至2019年12月我院收治的60例骨质疏松患者进行前瞻性研究,其中T2DM合并骨质疏松30例(A组),非T2DM的骨质疏松30例(B组)。两组均给予锝(99 Tc)亚甲基二磷酸盐、阿法骨化醇、维D钙咀嚼片,比较两组治疗前后腰椎(L2~L4)与髋部Ward三角区骨密度、血脂指标[高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)]、超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、心肌酶谱指标[肌酸激酶(CK)、乳酸脱氢酶(LDH)、门冬氨酸氨基转移酶(AST)、肌酸激酶同工酶(CK-MB)]水平、颈动脉内膜厚度、不良反应、心血管事件发生情况。结果治疗6个月后两组腰椎(L2~L4)与髋部Ward三角区骨密度均高于治疗前(P<0.05);治疗3、6个月后两组HDL-C水平较治疗前升高,LDL-C、TG、TC水平较治疗前降低(P<0.05);治疗3、6个月后两组hs-CRP、Hcy均较治疗前降低(P<0.05);两组治疗3、6个月后颈动脉内膜厚度均较治疗前降低(P<0.05)。结论锝(99 Tc)亚甲基二磷酸盐治疗T2DM合并骨质疏松及非糖尿病骨质疏松,均能改善患者血脂代谢,降低颈动脉内膜厚度,呈现出心血管保护效应,安全可靠。Objective To investigate the cardiovascular effects of technetium(99 Tc)methylene diphosphate in the treatment of type 2 diabetes mellitus(T2DM)with osteoporosis.Methods Sixty patients with osteoporosis admitted to our hospital from July 2017 to December 2019 were selected for prospective study.Among them,30 cases of T2DM combined with osteoporosis(group A),30 cases of non-T2DM osteoporosis(group B).Two groups were given chewable tablets of technetium(99 Tc)methylene diphosphate,alfacalcidol,vitamin D calcium.The bone mineral density between lumbar spine(L2~L4)and Ward’s triangle of hipsand blood lipid index[high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triacylglycerol(TG),total cholesterol(TC)],high-sensitivity C-reactive protein(hs-CRP),homocysteine(Hcy),myocardial enzyme spectrum index[creatine kinase(CK),lactate dehydrogenase(LDH),aspartate aminotransferase(AST),creatine kinase isoenzyme(CK-MB)]levels,the carotid intima thickness,adverse reactions,and cardiovascular events were compared before and after treatment of the two groups.Results After 6 months of treatment,the bone mineral density of the lumbar spine(L2~L4)and the Ward triangle of the hip was higher than before treatment(P<0.05).After 3 and 6 months of treatment,the levels of HDL-C in the two groups were higher than before treatment,while the levels of LDL-C,TG and TC were lower than before treatment(P<0.05).The hs-CRP and Hcy of the two groups after 3 and 6 months of treatment were lower than before treatment(P<0.05).The thickness of the carotid artery intima after 3 and 6 months of treatment in both groups was lower than before treatment(P<0.05).Conclusion Technetium(99 Tc)methylene diphosphate in the treatment of T2DM with osteoporosis and non-diabetic osteoporosis can improve blood lipid metabolism and reduce the thickness of carotid intima,present cardiovascular protection effect,safe and reliable.

关 键 词：锝(99 Tc)亚甲基二磷酸盐 2型糖尿病合并骨质疏松 心血管 血脂 颈动脉内膜厚度 

分 类 号：R587.2[医药卫生—内分泌]