辛伐他汀对老年高脂血症伴骨量减少病人骨代谢的干预研究

Effect of simvastatin on bone metabolism in elderly patients with osteopenia and hyperlipemia

目的:探讨辛伐他汀对老年高脂血症伴骨量减少病人骨代谢的影响。方法:收集86例确诊为高脂血症的病人,随机分为试验组(49例)和对照组(37例)。两组病人均给予相似饮食以及等剂量阿法骨化醇和复方氨基酸螯合钙,试验组在此基础上加用辛伐他汀40 mg/d,疗程3个月。于用药前、用药后3个月分别采集静脉血测定骨代谢指标及检查骨密度。结果:试验组和对照组病人用药后总碱性磷酸酶(TAP)及骨源性碱性磷酸酶(BAP)均有明显升高(P<0.01或P<0.05),试验组TAP及BAP比对照组用药后升高更显著(P<0.05)。试验组和对照组用药后尿脱氧吡啶啉与肌酐的比值、骨宽频超声衰减值差异均无统计学意义。结论:辛伐他汀短期内对骨形成的生化指标有促进作用,因时间较短,对骨吸收的生化指标和骨密度的影响尚无统计学意义,有待进一步研究。

Objective： To investigate the effect of simvastatin on bone metabolism in elderly patiants with osteopenia and hyperlipemia. Methods：Eighty-six elderly patients with osteopenia and hyperlipemia were enrolled and randomized into treatment group（49 cases） and control group（37 cases）. All subjects received equi-dosage alfacalcidol and compound calcium amino acid chelate capsules. The patients in treatment group additionally received simvastatin tablets （40 mg/d） for 3 months. The biochemical indicators of bone metabolism and the bone density were measured at the baseline and after 3-month treatment. Results： After the treatment,the levels of total alkaline phosphatase（TAP） and bone alkaline phosphatase（BAP） of the patients in the two groups were increased significantly（P〈0.01 or P〈 0.05）, and the increase was more significant in the treatment group （P〈0.05）. The ratio of urine deoxypyridinoline to creatinine（DPD/Cr） and bone broadband ultrasound attenuation （BUA） levels had no significant changes. Conclusion： Simvastatin can promote the bone formation of the elderly patients with osteopenia and hyperlipemia in short period,but the effects of simvastatin on bone resorption and density need to be studied further.