阿仑膦酸钠与阿法骨化醇对骨质疏松老年女性患者动脉硬化参数的影响

摘要

目的：探讨阿仑膦酸钠及阿法骨化醇联合治疗对2型糖尿病（T2DM ）合并骨质疏松老年女性患者动脉硬化的影响。方法：选取T2DM 合并骨质疏松老年女性28例作为骨质疏松组，T2DM 非骨质疏松老年女性25例作为对照组，给予骨质疏松组阿仑膦酸钠及阿法骨化醇联合治疗12个月，观察股骨颈和ward三角区骨密度（BMD）、T 值、踝臂指数（ABI）、心踝血管指数（CAVI）、颈动脉内膜中层厚度（IM T ）、糖化血红蛋白、血脂、血压的变化。结果与对照组比较，骨质疏松组BMD、T值及ABI明显下降（P＜0．01），而CAVI、IMT明显升高（P＜0．05）。与治疗前比较，骨质疏松组治疗12个月后动脉硬化参数ABI、CAVI及IM T无明显变化，而股骨颈、w ard三角BM D、T 值明显升高（ P＜0．05）；对照组的动脉硬化程度在12个月后较前加重（ P＜0．05），骨密度、T值无明显变化。结论：阿仑膦酸钠联合阿法骨化醇治疗T2DM合并骨质疏松老年女性患者能改善其动脉硬化参数，对其心脑血管疾病的防治有一定作用。%Objective To observe the effects of alendronate sodium and alfacalcidol on the parameters of atherosclerosis in old women with type 2 diabetes mellitus(T2DM ) complicating osteoporosis .Methods 28 old women with T2DM complicating osteopo-rosis were taken as the osteoporosis group and 25 old women with T2DM and without osteoporosis were taken as the control group .Alendronate sodium(70 mg/week) and alfacalcidol(0 .5 μg/d) were given to the osteoporosis group for 12 month .The pa-rameters of the bone mass density (BMD)of femoral neck and ,T value ,arkle brachial index (ABI) ,cardio-ankle vascular index (CAVI) and carotid artery intima-media thickness(IMT) ,blood fat and glycosylated hemoglobin were observed .Results Com-pared with the control group ,BMD ,T value and ABI in the osteoporosis group were significantly decreased (P<0 .01) ,while CAVI and IMT were obviously increased(P<0 .05) .Compared with before treatment ABI ,CAVI and IMT after 12 month treatment in the osteoporosis group had no significant changes ,but BMD and T value of femoral neck and ward triangle area were significantly increased(P<0 .05) ,the atherosclerosis degree after 12 months in the control group was significantly aggravated (P<0 .05) .BMD and T value had no obvious change .Conclusion Alendronate sodium combined with alfacalcidol for treating T 2DM complicating os-teoporosis can improve the atherosclerosis parameters and has certain role in preventing and treating cardiovascular and cerebrovas-cular diseases .