阿托伐他汀联合雌激素在绝经期骨质疏松女性患者中的应用价值

Clinical values of atorvastatin combined with estrogen in the management of menopausal women with osteoporosis

目的探讨阿托伐他汀联合雌激素在绝经期骨质疏松女性患者中的应用价值。方法自2013年1月—2015年11月,前瞻性收集金华市人民医院收治的绝经期伴有骨质疏松的女性患者80例,将患者随机分为实验组和对照组,实验组使用阿托伐他汀联合雌激素治疗,对照组仅使用雌激素治疗。主要观察指标为雌激素、降钙素、钙、磷、血清碱性磷酸酶、血清骨钙素、股骨颈骨矿物质密度。结果 2组患者治疗前后雌激素水平差异均无统计学意义(P>0.05)。治疗前2组患者降钙素差异无统计学意义[(191.18±49.12)pg/ml vs.(210.23±58.16)pg/ml,P=0.118];但治疗后实验组患者降钙素水平显著高于对照组[(262.10±72.50)pg/ml vs.(231.78±62.57)pg/ml,P=0.049]。治疗后2组患者钙、磷和碱性磷酸酶等差异均无统计学意义(P>0.05)。治疗后与对照组比较,实验组患者骨钙素显著增高[(11.53±2.69)μg/L vs.(9.05±2.27)μg/L,P=0.000]。治疗前2组患者骨密度差异无统计学意义[(0.49±0.03)g/cm2vs.(0.48±0.04)g/cm2,P=0.174],治疗后实验组患者骨密度显著增高[(0.54±0.03)g/cm2vs.(0.48±0.03)g/cm2,P=0.000]。结论阿托伐他汀联合雌激素有助于增加绝经期骨质疏松患者骨密度。

Objective To investigate the clinical values of atorvastatin combined with estrogen in the management of menopausal women with osteoporosis. Methods From January,2013 to November,2015,80 menopausal women with os- teoporosis were enrolled in this prospective study. All patients were randomly signed into the experiment group or control group. The experiment group received the management of atorvastatin combined with estrogen while the control group re- ceived estrogen only. The primary outcomes included the level of estrogen, calcitonin, calcium, phosphorus, serum alkaline phosphatase,serum osteocalein,and bone mineral density of femoral neck. Results There was no difference between the two groups in pre-treatment or post-treatment estrogen（ P 〉0.05 ）. No difference was observed in calcitonin before treatment [ （ 191.18± 49.12 ） vs. （ 210.23 ± 58.16 ） pg/ml, P = 0.118 ]. However, when compared with the control group, patients in the experiment group got a significant higher level of calcitonin after the treatment[ （262.10 ±72.50） pg/ml vs. （231.78 ±62.57） pg/ml,P=0.049） ]. There were no difference between the two groups in the level of calcium,phos- phorus, serum alkaline phosphatase（ P 〉 0. 05 ）, and a significant difference was observed in serum osteocalein when com- pared with the control group [ （ 11.53 ± 2.69）ug/L vs. （9.05± 2.27 ） ug/L, P 〈 0. 001 ]. There was no difference be- tween the two groups in bone mineral density before treatment [ （ 0.49 ± 0.03 ） g/em2 vs. （ 0.48 ± 0.04 ） g/cm2, P = 0. 174） ] while a significant higher level of bone mineral density was observed in bone mineral density after the treatment （0. 54 ±0. 03 ） g/cm2 vs. （0.48 ± 0.03 ） g/cm2, P = 0. 000 ]. Conclusion Atorvastatin combined with estrogen can in- crease the level of bone mineral density in menopausal women with osteoporosis.