目的 探索老年高血压并骨质疏松患者口服金天格胶囊对骨密度及骨代谢指标的影响.方法 选择2013年7月至2015年9月我院老年高血压并骨质疏松患者144例为研究对象,随机、双盲分为治疗组(n=72)和对照组(n=72).治疗组患者口服金天格胶囊+钙剂,对照组口服钙剂.两组观察12个月,测定治疗前及治疗后12个月的血清骨钙素(OC)、血清I型胶原C末端肽(s-CTX)、血清骨源性碱性磷酸酶(BAP)、血清骨硬化蛋白(SCL)和骨密度值(腰椎正位、股骨颈、前臂、股骨粗隆).结果 两组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12个月后,两组OC、BAP及腰椎正位、股骨颈、前臂、股骨粗隆的BMD显著增大,且s-CTX、SCL水平显著降低(P＜0.05);而治疗组治疗后OC、BAP、s-CTX、SCL及腰椎正位、股骨颈、前臂、股骨粗隆的BMD改变显著优于对照组(P＜0.05).结论 口服金天格胶囊可以通过改变骨代谢和抑制SCL表达而提高高血压合并骨质疏松患者的骨密度.%Objective To study the effect of oral administration of Jintiange capsule on bone mineral density,bone metabolism and sclerostin in elderly patients with hypertension and osteoporosis.Methods From July 2013 to September 2015,144 elderly patients with hypertension and osteoporosis were randomly divided into treatment group (n =72) and control group (n =72).The patients in the treatment group were treated with Jintiange capsule + calcium and the control group received calcium only.Serum levels of osteocalcin (OC),serum type I collagen C-terminal peptide (s-CTX),serum bone-derived alkaline phosphatase (BAP),serum osteogenic alkaline phosphatase (BAP),serum sclerostin (SCL) and bone mineral density [lumbar spine anteroposterior,femoral neck,femur trochanter and forearm] were measured at baseline and 12 months after treatment.Results At baseline,there were no significant differences between the two groups in bone mineral density,bone metabolic index and SCL (P ＞ 0.05).After 12 months of treatment,the levels of OC,BAP and BMD of lumbar spine,femoral neck,femur trochanter and forearm increased significantly,and the levels of s-CTX and SCL decreased significantly in both groups (P ＜ 0.05),with the improvements in OC,BAP,s-CTX,SCL and BMD of lumbar spine,femoral neck,forearm and femur significantly better in the Jintiange capsule + calcium group compared with the control group (P ＜ 0.05).Conclusion Oral Jintiange Capsule improves bone mineral density in patients with hypertension by influencing bone metabolism and suppressing SCL expression.
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