阿仑膦酸钠与他汀类降脂药联合治疗老年性骨质疏松伴高脂血症患者的临床观察

Clinical Observation on the Efficacy of Alendronate Combined with Atorvastatin in the Treatment of Patients with Hyperlipidemia Senile Osteoporosis

目的观察阿仑膦酸钠片联合他汀类降脂药治疗伴有高脂血症的老年性骨质疏松患者的临床疗效。方法将120例同时患有骨质疏松症和高脂血症的老年患者分为3组:联合治疗组、阿仑膦酸钠组、阿托伐他汀组,每组40例,治疗6个月,观察治疗前后骨密度(BMD)、血脂、血钙、磷、碱性磷酸酶(AKP)变化,疼痛的评价和临床疗效评定。结果各治疗组腰部、大转子和尺骨远端BMD检测结果较治疗前明显升高,且联合治疗组优于另外两组,差异有统计学意义(P<0.05)。联合治疗组及阿托伐他汀组血脂较治疗前下降明显,差异有统计学意义(P<0.05)。3组治疗前后血清钙、磷均无明显变化,差异无统计学意义(P>0.05);联合治疗组及阿仑膦酸钠片治疗组AKP下降明显,差异有统计学意义(P<0.05)。3组治疗前后VAS比较,差异有统计学意义(P<0.05),且联合治疗组优于另外两组,差异有统计学意义(P<0.05)。联合治疗组显效率和总有效率均明显高于其他两组,差异有统计学意义(P<0.05)。结论阿仑膦酸钠片和阿托伐他汀联合治疗骨质疏松伴高脂血症具有显著的临床疗效,优于单独使用阿仑膦酸钠或阿托伐他汀,两药联合具有协同作用,是临床防治骨质疏松症的一种非常有效的方法。

Objective To observe the efficacy of alendronate combined with atorvastatin in the treatment of patients with hyperlipidemia senile osteoporosis.Methods Totally 120 elderly patients with osteoporosis and hyperlipidemia were randomly divided into 3 groups：the combination therapy group,alendronate group,atorvastatin group,with 40 cases in each group and the treatment period of 6 months.Before and after treatment,changes of bone mineral density （BMD）,lipids,calcium,phosphorus,alkaline phosphatase （AKP）,evaluation of pain and evaluation of the clinical efficacy were detected.Results BMD test results of waist,the greater trochanter and distal ulna in treatment group were significantly shorter in combination therapy group compared with those in the other groups,and the difference was statistically significant （P 〈 0.05）.Blood lipids of combination therapy group and atorvastatin group were significantly decreased after treatment compared with before treatment,and the difference was statistically significant （P 〈 0.05）.Serum calcium,phosphorus of three groups did not have significantly change after treatment （P 〈 0.05）.AKP of combination therapy group and alendronate group were significantly decreased after treatment compared with before treatment,and the difference was statistically significant （P〈 0.05）.VAS scores of three groups were significantly decreased after treatment compared with before treatment,and the difference was statistically significant （P 〈 0.05）,and the combination therapy group was better than other groups,and the difference was statistically significant （P 〈 0.05）.Efficient and the total effective rate of combined treatment group were significantly higher than the other two groups,and the difference was statistically significant （P 〈 0.05）.Conclusion Alendronate tablets and atorvastatin combination therapy forosteoporosis with hyperlipidemia has significant clinical efficacy,better than alendronate alone or atorvastatin.Clinical efficacy of alendronate combined with atorvastatin in the treatment of patients with hyperlipidemia senile osteoporosis was significant,better than alendronate or atorvastatin alone.Two-drug combination has a synergistic effect,is a very effective method of clinical prevention and treatment of osteoporosis.