Objective To compare the effects of enalapril and simvastatin on bone mineral density and bone metabolism in elderly patients with hypertension and osteoporosis.Methods From July 2013 to September 2015,126 elderly patients with hypertension and osteoporosis were randomly divided into treatment group (n =63) and control group (n =63).Patients in the treatment group were treated with enalapril + simvastatin and those in the control group received enalapril only.Serum levels of osteocalcin (OC),type Ⅰ collagen C-terminal peptide (s-CTX),bone-derived alkaline phosphatase (BAP),tartrate-resistant phosphatase-5b (TRACP-5b) and bone mineral density (lumbar spine anteroposterior,femoral neck,forearm and greater trochanter) weremeasured at baseline and 6 months after treatment.Results There were no significant differences between the two groups in bone mineral density and bone metabolic index at baseline (P＞ 0.05).After treatment,OC,BAP and BMD of lumbar spine,femoral neck,forearm and greater trochanter significantly increased,and the levels of s-CTX and TRACP-5b significantly decreased (P ＜0.05) in both groups.After treatment,OC,BAP,s-CTX,TRACP-5b and BMD of lumbar spine,femoral neck,forearm and greater trochanter of the treatment group were significantly better than those in the control group (P ＜ 0.05).Conclusion Elderly hypertensive patients with osteoporosis received enalapril and simvastatin treatment for 6 months had significantly greater increase in bone mineral density than oral administration of enalapril alone.%目的 对比研究老年高血压并骨质疏松患者口服依那普利联合辛伐他汀对骨密度及骨代谢指标的效果.方法 选择2013年7月～2015年9月我院老年高血压并骨质疏松患者126例为研究对象,随机、双盲分为治疗组(n=63)和对照组(n=63).治疗组患者口服依那普利+辛伐他汀,对照组口服依那普利.两组观察6个月,测定治疗前及治疗后6个月的血清骨钙素(0C)、血清Ⅰ型胶原C末端肽(s-CTX)、血清骨源性碱性磷酸酶(BAP)、血清抗酒石酸酸性磷酸酶-5b(TRACP-5b)和骨密度值[腰椎正位、股骨颈、前臂、股骨粗隆]的水平.结果 两组各骨密度及骨代谢指标参数基线值比较,差异无统计学意义(P＞0.05).治疗后,两组OC、BAP及腰椎正位、股骨颈、前臂、股骨粗隆的BMD水平显著增大,且s-CTX、TRACP-5b水平显著降低(P＜0.05),而治疗组治疗后OC、BAP、s-CTX、T RACP-5b及腰椎正位、股骨颈、前臂、股骨粗隆的BMD水平改变显著优于对照组(P＜0.05).结论 老年高血压并骨质疏松患者给予口服依那普利和辛伐他汀治疗后6个月,较单纯口服依那普利骨密度值显著上升.
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