CAJ | 학술논문

目的：探讨中老年女性高血压患者与非高血压人群骨密度（ BMD）的差异及常用降高血压药物的使用情况与BMD的关系。方法采用横断面研究方法，1961例符合要求的女性（40～89岁）纳入研究，采用问卷调查收集一般情况、慢性病用药史、生活习惯等信息，测量血压、身高、体重，运用超声骨密度仪（型号：SAHARA）检测足跟部位 BMD，对相关数据进行统计学分析。结果高血压组中使用降压药物的 BMD 均值为（0．416±0．098）g／cm2，没有使用降压药物的BMD均值为（0．401±0．121）g／cm2，均显著低于非高血压组（P＜0．05）；控制混杂因素后，仍存在显著性差异（P＜0．05）。高血压患者中，使用降压药物的BMD均值高于没有用药组；控制变量后，两者比较存在统计学差异（P＜0．01）。单种降压药物使用的BMD均值显著高于两种或3种药物联合使用的情况（P＜0．05）；单种使用四类降压药物BMD均值的高低顺序为：血管紧张素转化酶抑制剂／血管紧张素受体抑制剂（ ACEI／ARB）类＞噻嗪类利尿剂＞钙通道拮抗剂＞β受体抑制剂。调整变量后，使用ACEI／ARB类或噻嗪类利尿剂者的BMD均值显著高于没有用药的高血压患者，与非高血压组比较没有显著差异（P＜0．05），使用钙通道拮抗剂者 BMD均值高于没有用药的高血压患者，低于非高血压组（P＜0．01）。使用β受体抑制剂者BMD均值显著低于使用其他三类药物的患者（P＜0．05）。结论中老年女性高血压与BMD降低有关；不同降高血压药物的使用者BMD存在差异。
목적：탐토중노년녀성고혈압환자여비고혈압인군골밀도（ BMD）적차이급상용강고혈압약물적사용정황여BMD적관계。방법채용횡단면연구방법，1961례부합요구적녀성（40～89세）납입연구，채용문권조사수집일반정황、만성병용약사、생활습관등신식，측량혈압、신고、체중，운용초성골밀도의（형호：SAHARA）검측족근부위 BMD，대상관수거진행통계학분석。결과고혈압조중사용강압약물적 BMD 균치위（0．416±0．098）g／cm2，몰유사용강압약물적BMD균치위（0．401±0．121）g／cm2，균현저저우비고혈압조（P＜0．05）；공제혼잡인소후，잉존재현저성차이（P＜0．05）。고혈압환자중，사용강압약물적BMD균치고우몰유용약조；공제변량후，량자비교존재통계학차이（P＜0．01）。단충강압약물사용적BMD균치현저고우량충혹3충약물연합사용적정황（P＜0．05）；단충사용사류강압약물BMD균치적고저순서위：혈관긴장소전화매억제제／혈관긴장소수체억제제（ ACEI／ARB）류＞새진류이뇨제＞개통도길항제＞β수체억제제。조정변량후，사용ACEI／ARB류혹새진류이뇨제자적BMD균치현저고우몰유용약적고혈압환자，여비고혈압조비교몰유현저차이（P＜0．05），사용개통도길항제자 BMD균치고우몰유용약적고혈압환자，저우비고혈압조（P＜0．01）。사용β수체억제제자BMD균치현저저우사용기타삼류약물적환자（P＜0．05）。결론중노년녀성고혈압여BMD강저유관；불동강고혈압약물적사용자BMD존재차이。
Objective To determine the relationship of hypertension and bone mineral density in mid-elderly women.Methods The questionnaire was used to collect the general information, drugs use, living habits of 1 961 qualified women.All participants underwent blood pressure, height and weight measurement.Bone mineral density was detected by calcaneus absorptiometry.Results ①The average BMD in hypertension group with antihypertensive was(0.416±0.098 )g/cm2,and without antihypertensive was (0.401±0.121) g/cm2,ei-ther of which was lower than that of non-hypertensive group.After adjustment for cofounders, the difference remained significant.②Among the hypertensive women, the average BMD was higher in group with antihypertensive, the difference was significant after adjustment for other factors.The group with single drug had higher average BMD than those with joint use of drugs.③Comparing the average BMD among four groups with each kind of single-used antihypertensive medication, the order was:ACEI/ARB>Thiazide diuretics>calcium channel blockers>βreceptor inhibitors.After adjustment for other factors, the average BMD in the group with use of ACEI/ARB or Thiazide diuretics was sig-nificant higher than that of hypertensive group without antihypertensive, and had no difference with the non-hypertensive group.The average BMD in the group with use of calcium channel blockers was higher than that of hypertensive group without antihypertensive, and lower than that of non-hypertensive group.The average BMD in the group with βreceptor inhibitors was significant lower than that of the groups with other three kinds of antihypertensive.Conclusions Hypertension is associated with reduced BMD in mid-elderly women.Divergence of BMD exists among women with different antihypertensive drugs.