伊班膦酸钠联合辛伐他汀治疗2型糖尿病合并骨质疏松的临床研究-东南大学学报医学版

伊班膦酸钠联合辛伐他汀治疗2型糖尿病合并骨质疏松的临床研究

作者：李军庄贺

单位：聊城中医院, 山东聊城 252200

分类号：R587.1

出版年·卷·期（页码）：2014·33·第五期（601-604）

摘要：

目的：探讨伊班膦酸钠联合辛伐他汀治疗对2型糖尿病（T2DM）合并骨质疏松症患者骨代谢指标（TRACP-5b、s-CTX、BAP、OC）及骨密度（BMD）的影响，为临床治疗T2DM合并骨质疏松症提供参考。方法：选择T2DM合并骨质疏松症患者115例，随机分为观察组（n=58）和对照组（n=57）。对照组给予常规治疗加用伊班膦酸钠注射液，观察组在对照组基础上联用辛伐他汀。观察两组治疗前、治疗12个月后血Ca、P、ALP、s-CTX、TRACP-5b、BAP、OC及BMD的变化。结果：观察组治疗12个月后TRACP-5b、s-CTX明显低于对照组（P<0.05），BAP、OC水平则明显高于对照组（P<0.05）。观察组治疗12个月后腰椎L_2~4、股骨颈的BMD明显高于对照组（P<0.05）。结论：伊班膦酸钠联合辛伐他汀治疗T2DM合并骨质疏松症可有效促进骨形成、抑制骨吸收、增加骨BMD，疗效明显优于单纯伊班膦酸钠。提示在防治T2DM合并骨质疏松症时，除了给予抑制骨吸收、促骨形成的药物治疗外，还应积极治疗T2DM，控制影响骨代谢的危险因素，如降血糖、改善胰岛素缺乏和脂代谢异常等，以进一步提高临床疗效。

Objective: To investigate the bone metabolic markers (TRACP-5b,s-CTX, BAP, OC)and bone mineral density (BMD) of patient with type 2 diabetes mellitus (T2DM) who was treated by ibandronate combined with simvastatin, in order to provide reference for clinical treatment of T2DM complicated with osteoporosis. Methods: One hundred and fifteen cases of patients with T2DM complicated with osteoporosis were randomly divided into observation group (n=58) and control group (n=57). Patients in control group were given with ibandronate injection combined with conventional therapy, patients in observation group were treated with simvastatin on basis of treatment of patients in control group. The blood Ca, P, ALP, s-CTX, TRACP-5b,BAP, OC and BMD of patiets in two groups before treatment or at posttreatment 12 months were observed. Results: The TRACP-5b, s-CTX at posttreatment 12 months in observation group were significantly lower than those in control group (P<0.05), the BAP,OC levels were significantly higher than those in control group (P<0.05). The BMD of lumbar L_2-4, femoral neck in observation group at posttreatment 12 months were higher than that in control group (P<0.05). Conclusion: Treating T2DM complicated with osteoporosis by ibandronate combined with simvastatin can effectively promote bone formation, inhibit bone resorption,increase BMD, its curative effect is obviously better than sodium ibandronate. Therefore,in prevention and treatment of T2DM complicated with osteoporosis, in addition to using drug about inhibiting bone resorption,promoting bone formation, actively treating T2DM, controlling effect of risk factors of bone metabolism such as lowering blood glucose, improving insulin deficiency and abnormal lipid metabolism should be done, so that clinical efficacy is further improved.

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