阿托伐他汀联合阿司匹林对绝经期冠心病妇女骨密度及骨生化和代谢的影响

Effect of atorvastatin combined with aspirin on bone mineral density and bone biochemistry and metabolism in postmenopausal women with coronary heart disease

目的观察阿托伐他汀联合阿司匹林对绝经期冠心病妇女骨密度及骨生化和代谢的影响。方法 60名绝经后冠心病患者,按随机数字表法将其分为治疗组(n=30)、及对照组(n=30)。对照组给予阿司匹林治疗,治疗组给予阿托伐他汀联合阿司匹林治疗,12个月。测定治疗不同时间段患者,腰椎1-4(L1-4)、股骨颈、股骨大转子及全髋BMD及血钙(Ca)、血磷(P)、血清1型前胶原N端前肽(P1NP)及1型胶原羧基端降解产物(β-CTX)水平的变化情况。结果治疗后6个月及12个月,两组患者的骨密度都有不同程度提高,治疗组腰椎1-4(L1-4)、股骨颈、股骨大转子及全髋骨密度均显著高于同时期对照组(P<0.05);治疗后6个月及12个月,两组患者的血Ca、P、β-CTX及P1NP都有不同程度改变,血Ca、P、β-CTX较治疗前明显下降,P1NP明显上升(P<0.05),而治疗组改变明显高于同期对照组(P<0.05)。结论阿托伐他汀联合阿司匹林提升绝经期冠心病妇女患者骨密度,改善骨生化和代谢状态。

Objective To observe the effect of atorvastatin combined with aspirin on bone mineral density and bone biochemistry and metabolism in postmenopausal women with coronary heart disease. Methods Sixty patients with postmenopausal coronary heart disease were divided into treatment group（ n = 30） and control group（ n = 30） according to a random number tablemethod.Patients in the control group and the treatment group received aspirin and atorvastatin plus aspirin,respectively,for 12 months.Bone mineral density（ BMD） of the lumbar spine 1-4（ L1-4）,femoral neck,femur greater trochanter,and total hip,and the levels of serum calcium（ Ca）,phosphorus（ P）,type 1 procollagen N-terminal propeptide（ P1NP）,and type 1 collagen carboxy terminal degradation products（ β-CTX） were tested and recorded. Results After 6 months and 12 months of the treatment,BMD of the two groups increased in different degrees. BMD of L1-4,femoral neck,femur greater trochanter,and total hip increased significantly（ P〈0. 05）. After 6 months and 12 months of the treatment,the levels of Ca,P,β-CTX,and P1 NP in the two groups changed to different degrees. Ca,P,and β-CTX increased significantly（ P〈0. 05）. The changes in the treatment group was significantly more than those in the control group（ P〈0. 05）. Conclusion Atorvastatin combined with aspirin improves BMD and bone biochemical and metabolic status in women with postmenopausal coronary heart disease.