CAJ | 학술논문

目的：探讨普伐他汀联合伊班膦酸钠治疗老年糖尿病伴骨质疏松症的疗效。方法选择2010年2月至2013年1月在平邑县人民医院住院治疗的老年糖尿病伴骨质疏松症患者107例为研究对象，按抽签法将患者分为两组：伊班膦酸钠组（ n＝55）患者在给予糖尿病治疗的基础上加用伊班膦酸钠治疗，联合组（ n＝52）在伊班膦酸钠组的基础上加用普伐他汀治疗。连续治疗12个月后，观察两组患者治疗前后骨代谢指标及骨密度的变化情况。结果治疗后，两组患者血清Ⅰ型胶原C末端肽（s－CTX）、血清抗酒石酸酸性磷酸酶－5b（TRACP－5b）的水平与治疗前相比显著降低（P＜0.05），骨源性碱性磷酸酶（BAP）、骨钙素水平则显著增高（P＜0.05），且治疗后联合组 TRACP－5b、s－CTX显著低于伊班膦酸钠组（P＜0.05），BAP、骨钙素显著高于伊班膦酸钠组（P＜0.05）；联合组 L2～4、股骨颈、股骨粗隆、Ward三角区骨密度均较治疗前显著增高（P＜0.05），且联合组显著高于伊班膦酸钠组（P＜0.05）。结论普伐他汀联合伊班膦酸钠治疗老年糖尿病伴骨质疏松症的效果优于单纯应用伊班膦酸钠。
목적：탐토보벌타정연합이반련산납치료노년당뇨병반골질소송증적료효。방법선택2010년2월지2013년1월재평읍현인민의원주원치료적노년당뇨병반골질소송증환자107례위연구대상，안추첨법장환자분위량조：이반련산납조（ n＝55）환자재급여당뇨병치료적기출상가용이반련산납치료，연합조（ n＝52）재이반련산납조적기출상가용보벌타정치료。련속치료12개월후，관찰량조환자치료전후골대사지표급골밀도적변화정황。결과치료후，량조환자혈청Ⅰ형효원C말단태（s－CTX）、혈청항주석산산성린산매－5b（TRACP－5b）적수평여치료전상비현저강저（P＜0.05），골원성감성린산매（BAP）、골개소수평칙현저증고（P＜0.05），차치료후연합조 TRACP－5b、s－CTX현저저우이반련산납조（P＜0.05），BAP、골개소현저고우이반련산납조（P＜0.05）；연합조 L2～4、고골경、고골조륭、Ward삼각구골밀도균교치료전현저증고（P＜0.05），차연합조현저고우이반련산납조（P＜0.05）。결론보벌타정연합이반련산납치료노년당뇨병반골질소송증적효과우우단순응용이반련산납。
Objective To investigate the effect of pravastatin combined with ibandronate on senile dia-betes complicated by osteoporosis.Methods A total of 107 elderly patients with diabetes complicated by os-teoporosis admitted in Pingyi People′s Hospital from Feb.2010 to Jan.2013 were selected as research objects and were divided into combination group(n=52) and ibandronate group(n=55) by drawing lots.Patients in ibandronate group were given ibandronate on the basis of general diabetes treatment and patients in combi-nation group were given pravastatin on the basis of treatment in ibandronate group After continuous treatment for 12 month,changes of the bone metabolism markers and bone mineral density ( BMD) of the two groups be-fore and after treatment were observed.Results After treatment,the serum levels of type Ⅰ collagen C-ter-minal peptides(s-CTX),and tartrate-resistant acid phosphatase-5b(TRACP-5b) of the two groups were sig-nificantly lower than those before treatment,while levels of bone alkaline phosphatase(BAP) and osteocalcin of the two groups were significantly higher than those before treatment(P<0.05),moreover,levels of s-CTX and TRACP-5b of the combination group decreased more significantly than ibandronate group(P<0.05), and levels of BAP and osteocalcin increased more significantly than ibandronate group(P<0.05).The BMD of lumbar L2-4 ,femoral neck,greater trochanter of femur and Ward of the combination group were significantly higher after treatment than those before treatment and those of ibandronate group(P<0.05).Conclusion The effect of pravastatin combined with ibandronate on senile diabetes complicated by osteoporosis is superior to that of the single application of ibandronate.