阿托伐他汀对老年冠心病患者骨密度的影响

Effects of atorvastatin on bone mineral density in elderly coronary heart disease patients

目的:探讨常规剂量阿托伐他汀对老年冠心病患者骨密度的影响。方法:对冠状动脉造影检查确诊的冠心病患者94例,根据其血浆LDL-C水平给予阿托伐他汀10～20mg/d(平均13.65mg/d),治疗1年。对照组为87例同期在心血管病房住院的年龄及性别相匹配的其他患者。于入院时及随访1年后以数字式放射吸收测量法测定左手第2、3、4手指中节指骨的相对骨矿物质密度(BMD),并检测治疗前后血TC及LDL-C浓度。结果:1年后,治疗组患者血TC浓度降低25.86%[(5.22±0.97)mmol/L∶(3.87±0.42)mmol/L,P<0.01],LDL-C浓度均降低24.71%[(3.06±0.60)mmol/L∶(2.26±0.41)mmol/L,P<0.01],手指BMD增加5.78%[(0.588±0.061)g/cm2∶(0.622±0.046)g/cm2,P<0.01]。对照组患者血TC浓度[(4.37±1.03)mmol/L∶(4.67±0.49)mmol/L]及LDL-C浓度[(2.61±0.61)mmol/L∶(2.74±0.26)mmol/L,均差异无统计学意义,P>0.05],手指BMD降低0.13%[(0.596±0.062)g/cm2∶(0.585±0.047)g/cm2,P>0.05]。1年后BMD的变化2组相比差异有统计学意义(5.78%∶-0.13%,P<0.01)。结论:常规剂量的阿托伐他汀治疗降低血胆固醇水平的同时能增加老年冠心病患者BMD,改善患者的骨质疏松。

Objective：To investigate the effects of atorvastatin on bone mineral density （BMD） in elderly patients with CHD. Method：The total of 94 consecutive elderly patients （≥50 years with 68 men and 26 women ） with CHD, who have been diagnosed by coronary artery angiograph were treated for 12 months with 10--20 mg/ day atorvastatin（mean 13.65 mg/d） according to their baseline low-density lipoprotein cholesterol （LDL-C） levels and 87 age-and gender-matched patients without using statins provided control data. In all subjects, at baseline and after 1 year, plasma total cholesterol（TC） and LDL-C were measured in a fasting blood sample, while BMD was measured at the finge of left hang by dual energy x-ray absorpiometry （DEXA）： Resuit：There were no significant differences between control and treatment groups in age, sex, body mass index, and baseline serum TC and LDL- C levels. In the group treated by atorvastatin, plasma TC levels reduced by 25.86% [（5.22±0.97） mmol/L ： （3.87±0.42） mmol/L, P〈0.01] and LDL-C levels reduced by 24.71% [（3.06±0.60） mmol/L ： （2.26±0.41） mmol/L, P〈0.01], while BMD showed a significant increase [（0. 588±0. 061） g/cm^2 ： （0. 622±0. 046） g/cm^2, P〈 0. 01] during the 1-year follow-up period. In the controls grop, BMD showed a slight decrease [（0.596±0.062）g/cm^2 ： （0.585±0.047） g/cm^2, P〉0.05] at the end of the study period. Percentage increments of BMD in the treatment group were significantly higher than in the control group（5.78% ： -0.13%, P〈 0.01）. Conclusion：This Study indicates that chronic administration of atorvastatin in old coronary heart disease patients exerts a beneficial effect on BMD.