阿托伐他汀联合阿仑膦酸钠对糖尿病合并骨质疏松患者骨密度的影响分析

Effect of Atorvastatin combined with Alendronate on bone density in patients with diabetes mellitus and osteoporosis

目的探讨阿托伐他汀联合阿仑膦酸钠对糖尿病合并骨质疏松患者骨密度的影响。方法采用前瞻性对比研究,选取2017年9月至2018年9月海南省干部疗养院(海南省老年病医院)收治的糖尿病合并骨质疏松患者118例,按照随机数字表法将患者分为两组:观察组和对照组,每组各59例。观察组患者给予阿托伐他汀联合阿仑膦酸钠治疗,对照组患者给予阿仑膦酸钠治疗。两组患者均治疗6个月。比较两组患者的血钙、血磷、疼痛视觉模拟评分(VAS)、骨密度(腰椎正位、前臂、股骨粗隆及股骨颈骨)、骨代谢[血清骨钙素(BGP)、骨保护素(OPG)、骨源性碱性磷酸酶(NBAP)、I型胶原氨基末端肽(NTx)]的变化、不良反应(头痛、腹痛、便秘、恶心、呕吐)发生情况及临床疗效。结果治疗后,观察组患者的总有效率(96.61%)明显高于对照组(71.19%),差异具有统计学意义(P<0.05)。治疗后,观察组患者的疼痛VAS评分由(7.35±1.45)分降至(1.58±0.32)分,明显低于对照组患者(2.76±0.55)分,差异均具有统计学意义(P<0.05)。治疗后,两组患者的腰椎正位、前臂、股骨粗隆及股骨颈骨密度水平均明显升高,且观察组显著高于对照组,差异均具有统计学意义(P<0.05)。治疗后,两组患者的BGP、OPG、NBAP水平均显著升高,且观察组明显高于对照组,差异均具有统计学意义(P<0.05);治疗后,两组患者的NTx水平均显著降低,且观察组明显低于对照组,差异均具有统计学意义(P<0.05)。观察组和对照组患者治疗期间不良反应发生率分别为13.56%、15.25%,组间比较差异无统计学意义(P>0.05)。结论阿托伐他汀联合阿仑膦酸钠治疗糖尿病合并骨质疏松临床疗效显著,能明显减轻患者的疼痛症状,提高患者的骨密度,调节骨代谢异常,且安全性高,有利于患者更好更快地恢复。

Objective To investigate the effect of Atorvastatin combined with Alendronate on bone density in patients with diabetes mellitus combined with osteoporosis.Methods According to the random number method,118 patients with diabetes combined with osteoporosis admitted to cadre sanatorium of hainan province(hainan geriatric hospital)from September 2017 to September 2018 were divided into two groups according to the random number table method,including observation group and control group,with 59 cases in each group.The observation group was treated with Alendronate and Atorvastatin,the control group was treated with Alendronate,both groups were treated for 6 months.The blood calcium,phosphorus,visual analogue scale(VAS)pain,bone mineral density(lumbar is,forearm,femoral trochanter and femoral neck bone,bone metabolism[bone glaprotein propeptide(BGP),osteoprotegerin(OPG),bone alkaline phosphatase(NBAP),N-terminal telopeptide of type I collagen(NTx)]amino terminal changes,adverse reactions(headache,nausea,vomiting,abdominal pain,constipation)occurrence and clinical curative effect in the two groups were compared.Results After treatment,the total effective rate of the observation group was 96.61%,which was significantly higher than that of the control group(71.19%)(P<0.05).After treatment,the VAS scores in the observation group were significantly decreased from(7.35±1.45)points to(1.58±0.32)points,significantly lower than that in the control group(2.76±0.55)points,with statistically significant differences(P<0.05).After treatment,the bone mineral density of the lumbar spine,forearm,femoral trochanter and femoral neck of the two groups of patients were significantly increased,and the observation group was significantly higher than the control group,with statistically significant differences(P<0.05).After treatment,the levels of BGP,OPG and NBAP in both groups were significantly increased,and those of the observation group was significantly higher than those in the control group,with statistically significant differences(P<0.05).After treatment,the level of NTx in both groups was significantly lower in the observation group than that in the control group,with statistically significant difference(P<0.05).The incidence of adverse reactions in the observation group and the control group were 13.56%and 15.25%,and the difference was not statistically significant(P>0.05).Conclusion Atorvastatin combined with Alendronate is effective in the treatment of diabetes mellitus with osteoporosis.It can significantly alleviate the pain symptoms,improve the bone density of patients,regulate abnormal bone metabolism,and have high safety,which will help patients recover better and faster.