ACEI对绝经后骨质疏松症伴高血压患者SOST的影响研究

Effect of ACEI on SOST in postmenopausal osteoporosis patients with hypertension

目的探讨ACEI对绝经后骨质疏松症伴高血压患者SOST的影响。方法将30例绝经后骨质疏松症伴高血压患者随机分为培哚普利组15例用培哚普利治疗,氨氯地平组15例用氨氯地平治疗;另选绝经后骨质疏松症不伴高血压患者15例作为对照组;三组患者均同时服用碳酸钙片及阿仑膦酸钠维D3片,共治疗6个月。用ELISA方法测定治疗前后血清Ⅰ型胶原C末端肽(β-CTX)、骨特异性碱性磷酸酶(BALP)、硬骨蛋白(SOST);用双能X线测量治疗前后股骨BMD值。结果三组治疗6月后SOST均较治疗前下降(P<0.05),培哚普利组下降明显,有显著性差异(P<0.01);三组治疗6月后BMD均较治疗前增高(P<0.05),培哚普利组升高明显(P<0.01);三组骨代谢指标β-CTX、BALP均较前下降(P<0.05),培哚普利组下降明显有显著性差异(P<0.01)。组间比较,相对于对照组,培哚普利组SOST、β-CTX、BALP下降明显,有差异(P<0.01或P<0.05);BMD升高明显,有显著性差异(P<0.01);治疗后对照组与氨氯地平组SOST、BMD、β-CTX、BALP组间比较无差异(P>0.05)。结论培哚普利可使绝经后骨质疏松症伴高血压患者的SOST下降,且作用与血压下降无关。

Objective To investigate the effect of ACEI on SOST in postmenopausal osteoporosis patients with hypertension.Methods Thirty patients with postmenopausal osteoporosis and hypertension were randomly divided into perindopril group(15 patients),amlodipine group(15 patients)and control group(15 patients without postmenopausal osteoporosis and hypertension).All patients in the three groups were given calcium carbonate tablets and alendronate vitamin D3 tablets.The treatment lasted for 6 months.Serum type I collagen C-terminal peptide(beta-CTX),bone specific alkaline phosphatase(BALP)and osteoprotein(SOST)were measured by ELISA before and after treatment,and BMD of femur was measured by dual-energy X-ray before and after treatment.Results After 6 months of treatment,SOST were all decreased significantly among three groups(P<0.05),but the perindopril group decreased more significantly(P<0.01).BMD were all increased significantly in three groups(P<0.05),while perindopril group increased more significantly(P<0.01).Bone metabolism index beta-CTX and BALP were all decreased significantly in three groups(P<0.05),while perindol group decreased more significantly(P<0.01).Compared with the control group,SOST,beta-CTX and BALP in perindopril group decreased more significantly(P<0.01 or P<0.05),and BMD increased more significantly(P<0.01);There were no differences about all indexes between the control group and amlodipine group after treatment(P>0.05).Conclusion Perindopril can decrease SOST in postmenopausal osteoporosis patients with hypertension,and the effect is not related to the decrease of blood pressure.