阿仑膦酸钠联合阿托伐他汀钙片治疗老年骨质疏松临床效果

Clinical Effect of Atorvastatin Combined with Alendronatein the Treatment of Senile Osteoporosis

目的:探究阿托伐他汀钙片联合阿仑膦酸钠治疗老年性骨质疏松的临床疗效及对血清学指标的影响,为临床合理用药提供依据。方法:选取2016年1月~2017年1月至我院就诊的老年骨质疏松患者共149例,按照随机数表法分为对照组(n=75)与观察组(n=74),对照组患者接受阿仑膦酸钠与阿法骨化醇口服治疗,观察组在此基础上加用阿托伐他汀钙片治疗,治疗周期为24周。比较两组患者骨质疏松治疗效果、VAS疼痛评分、各部位骨密度、血清学指标变化及不良反应发生率。结果:观察组骨质疏松治疗有效率为91.89%,明显高于对照组有效率74.67%(P<0.05)。观察组VAS评分的有效率为81.08%,明显高于对照组VAS评分的有效率62.67%(P<0.05)。治疗后,观察组VAS值明显低于对照组(P<0.05)。观察组左侧股骨、左侧股骨颈、L 2~4、Ward三角区及股骨粗隆的骨密度均明显高于对照组(P<0.05)。两组患者血清骨钙素(BGP)较治疗前升高(P<0.05),Ⅰ型胶原氨基末端肽(NTx)、Ⅰ型胶原羧基末端肽(CTx)、甲状旁腺素(PTH)、血清中抗酒石酸酸性磷酸酶-5b(TRACP-5b)较治疗前明显降低(P<0.05)。治疗后,观察组NTx、CTx、PTH水平较对照组低(P<0.05)。两组患者不良反应发生率无统计学差异(P>0.05)。结论:阿托伐他汀钙片联合阿仑膦酸钠治疗老年性骨质疏松有较好的临床效果,可降低患者的VAS评分,有效增加骨密度,能降低血清NTx与CTx水平,降低血清PTH水平,安全可靠,值得临床广泛应用。

Objective:To explore the clinical efficacy of atorvastatin combined with alendronate in the treatment of senile osteoporosis and its influence on serological indexes,so as to provide evidence for rational clinical drug use.Methods:From January 2016 to January 2017,149 elderly patients with osteoporosis admitted in our hospital were randomly divided into control group(n=75)and observation group(n=74).The control group received alendronate and alfacalcidol oral treatment,and the observation group received additional atorvastatin calcium tablets on this basis.The treatment period was 24 weeks.The treatment effect of osteoporosis,VAS pain score,bone mineral density of each part,the change of serological index and the incidence of adverse reaction were compared between the two groups.Results:The effective rate of osteoporosis treatment in the observation group was 91.89%,which was significantly higher than 74.67%of the control group(P<0.05).The effective rate of VAS score in the observation group was 81.08%,which was significantly higher than 62.67%of the control group(P<0.05).After treatment,the value of VAS in the observation group was significantly lower than that of the control group(P<0.05).The bone density of the left femur,the left femur neck,the L 2~4,the ward triangle and the trochanter of the femur in the observation group were significantly higher than that of the control group(P<0.05).The serological index of two groups with BGP was higher than before treatment(P<0.05),NTx,CTx PTH,TRACP-5b were significantly lower than before the treatment(P<0.05).After treatment,the level of NTx,CTx and PTH in the observation group was lower than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Atorvastatin combined with alendronate shows good clinical effect in the treatment of senile osteoporosis.It can reduce VAS score,increase bone mineral density,reduce serum NTx and CTx level,and decrease serum PTH level.It is safe and reliable,and is worthy of clinical application.