辛伐他汀对合并高胆固醇血症非手术治疗老年髋臼骨折愈合的影响

Effect of simvastatin on the nonoperative treatment of acetabular fracture healing in elderly patients with hypercholesterolemia

目的调查口服辛伐他汀是否可以改善骨密度、促进髋臼骨折愈合。方法收集2017年1月~2019年12月冀中能源峰峰集团有限公司总医院诊断为髋臼骨折共98例患者的信息:年龄、性别、肝功能、肾功能、血糖、血脂、凝血功能、心电图、骨密度。随机将患者分别对照组和实验组:对照组给予唑来膦酸钠注射液静脉滴注5mg;实验组给予唑来膦酸钠注射液静脉滴注5 mg,辛伐他汀口服每晚20 mg。对所有患者进行了为期12个月的定期临床和影像学随访。在基线、伤后4个月、伤后8个月、伤后12个月进行骨盆X线及健髋腰椎骨密度检查,并以重复测量方差分析及广义估计方程进行重复测量数据的比较。结果时点对健侧全髋骨密度及腰椎骨密度主效应显著,组别主效应不显著;伤后4个月的骨折愈合程度等于伤后12个月的2%,伤后8个月的骨折愈合程度等于伤后12个月的12%,不同的治疗方式对骨折愈合程度影响不具有统计学意义的差异,时点对骨折愈合存在显著影响。结论辛伐他汀不具有加强唑来膦酸钠改善骨密度、促进骨折愈合的作用。

Objective To investigate whether oral simvastatin can improve bone mineral density and to affect the rate of fracture healing in humans.Methods Individuals who had sustained an acetabular fracture from January 2017 to December2019 were recruited from Jizhong Energy Fengfeng Group General Hospital.The following information of patients was collected:Age,sex,liver function,kidney function,blood glucose,blood lipid and cholesterol,coagulation function,electrocardiogram,bone density.Patients were randomly assigned to either a control group or an experimental group.Patients in the control group were given intravenous infusion of zoledronic acid injection 5 mg once,while patients in the experimental group received intravenous infusion of zoledronic acid injection 5 mg once,and oral simvastatin was given 20 mg every night.Regular clinical and radiological follow-up was undertaken for a 12-month period.Dual-energy X-ray absorptiometry assessment of bone mineral density and X-ray of the pelvis was conducted at baseline,4-,8- and 12-month post injury.The data are compared by repeated measure ANOVA and generalized estimation equation.Results The total hip bone density and lumbar spine bone density on the undamaged side showed significant changes over time.The degree of fracture healing at 4 months after injury was equal to 2% at 12 months after injury,and the degree of fracture healing at 8 months after injury was equal to 12% at 12 months after injury.There was no statistically significant difference between different treatment methods on the degree of fracture healing.The time point has a significant effect on fracture healing.Conclusion Simvastatin does not improve bone density and fracture healing by enhancing zoledronic acid sodium.