β受体阻滞剂比索洛尔对老年原发性高血压患者骨代谢的影响

The effect of β blocker on bone metabolism of the elderly patients with hypertension

目的观察β受体阻滞剂比索洛尔对老年原发性高血压患者骨质密度及骨折发生率的影响。方法选择老年男性原发性高血压患者150例,按是否服用β受体阻滞剂比索洛尔分为治疗组(85例,比索洛尔5 mg/d,连续服用3年)和对照组(65例)。分别比较两组血清钙、磷、碱性磷酸酶浓度;并分析骨密度及骨折发生率。结果治疗组血清钙、磷、碱性磷酸酶浓度与对照组比较,差异均无统计学意义(P>0.05);治疗组患者用药3年后骨折4例(4.7%),对照组患者3年后骨折7例(10.8%),治疗组较对照组骨折发生率虽有下降,但差异无统计学意义(P>0.05);与用药前骨密度比较,治疗组用药3年后骨密度明显增高[(1.04±0.11)g/cm^2vs(1.49±0.13)g/cm^2,P<0.05];与对照组3年后骨密度比较,治疗组用药3年后骨密度也明显增高[(1.06±0.12)g/cm^2vs(1.49±0.13)g/cm^3,P<0.05]。结论长期服用治疗剂量β受体阻滞剂比索洛尔的老年原发性高血压患者骨密度明显增高,骨折发生率下降,但血清钙代谢未受到影响。

Objective To observe the effect of beta-blocker, bisoprolol, on bone mineral density （BMD） and fracture rate of the elderly patients with hypertension. Methods 150 elderly male patients with hypertension were selected. The patients were divided into group treated with bisoprolol（85 cases,5 mg qd） and control group without bisoprolol（65 cases）. The patients in the treatment group took bisoprolol more than 3 years. The serum levels of calcium, phosphorus and alka- line phosphatase,BMD and fracture rate were compared between two groups. Results There was no significant difference in serum levels of calcium,phosphorus and alkaline phosphatase between the 2 groups （P〉 0.05）. There were 4 fracture cases in treatment group（fracture rate 4.7%） and 7 fracture cases in control group（fracture rate 10.8%）. There was no significant statistical difference in fracture rate between the two groups （P 〉 0.05）, although it was lower in treatment group than in control group. There was significant difference in BMD between before and after treatment with bisoprolol for 3 years in the treatment group[（1.04±0. 11） g/cm^2vs （1.49± 0.13） g/cm^2 , P 〈 0. 05]. There was significant difference in BMD between the 2 groups after 3 years of treatment[（1.06±0.12） g/cm^2 vs （1.49±0.13） g/cm^2, P 〈 0. 05]. Conclusion The BMD was obviously increased and the morbidity of fracture was reduced in the elderly patients with hypertension who have taken beta-blocker bisoprolol for a long time,but the serum calcium metabolism was not influenced.