唑来膦酸联合瑞舒伐他汀治疗老年糖尿病合并骨质疏松对患者骨代谢影响.docVIP

唑来膦酸联合瑞舒伐他汀治疗老年糖尿病合并骨质疏松对患者骨代谢影响 　　[摘要] 目的 探讨唑来膦酸联合瑞舒伐他汀治疗老年糖尿病合并骨质疏松对患者骨代谢的影响。方法 方便选取该院2015年5月―2016年5月期间收治的老年2型糖尿病且合并骨质疏松的患者100例，将其随机分为对照组和实验组，每组50例。其中，对照组给予常规疗法治疗，实验组在对照组基础上联合应用瑞舒伐他汀。比较两组患者治疗前和治疗后1年的骨代谢指标如血钙（Ca）、血磷（P）、血清I型胶原C末端肽（s-CTX）、碱性磷酸酶（ALP）、抗酒石酸酸性磷酸酶（TRACP）-5b，骨密度（BMD）变化情况及不良反应的发生情况。结果 治疗后，实验组患者的P、Ca、ALP水平分别为（1.35±0.23）mmol/L、（2.24±0.41）mmol/L、（73.54±10.77）IU/L，和治疗前相比明显升高，差异有统计学意义（P0.05）；实验组患者的s-CTX和TRACP-5b分别为（0.21±0.09）ng/mL、（4.27±0.48）U/L，和治疗前相比明显降低（P0.05）；实验组不良反应发生率为6%（1例胃肠胀气，2例发热），对照组为8%（1例发热、2例胃肠胀气、1例腹痛），两组患者治疗所致不良反应的发生率差异无统计学意义（P0.05），均未发生严重并发症。结论 唑来膦酸联合瑞舒伐他汀治疗老年糖尿病合并骨质疏松，可以有效地提高骨密度，阻碍骨吸收改善骨代谢，且不良反??较少，疗效由于单独应用唑来膦酸。 　　[关键词] 唑来膦酸；瑞舒伐他汀；糖尿病；骨质疏松；骨代谢 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）12（b）-0021-03 　　[Abstract] Objective To study the effect of zoledronic acid combined with rosuvastatin treatment of senile diabetes and osteoporosis on the bone metabolism of patients. Methods 100 cases of senile patients with type 2 diabetes and osteoporosis admitted and treated in our hospital from May 2015 to May 2016 were convenient selected and randomly divided into two groups with 50 cases in each， the control group adopted the routine method， while the experimental group adopted the rosuvastatin on the basis of the control group， and the changes of Ca， P， s-CTX， ALP， （TRACP）-5b and BMD and occurrence of adverse reactions before treatment and after 1-year treatment were compared between the two groups. Results The P，Ca，ALP levels of patients in the experimental group were respectively （1.35±0.23）mmol/L，（2.24±0.41）mmol/L，（73.54±10.77）IU/L， which obviously increased， and the differences were statistically significant（P0.05）， and the s-CTX and TRACP-5b in the experimental group were respectively（0.21±0.09）ng/mL，（4.27±0.48）U/L， which obviously decreased compared with those before treatment（P0.05）， and the incidence rate of adverse reactions in the experimental group and in the control group was respectively 6% （1 case with flatulence and 2 cases with fever）