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目的:探讨常规剂量阿托伐他汀对老年冠心病患者骨密度的影响。方法:对冠状动脉造影检查确诊的冠心病患者94例,根据其血浆LDL-C水平给予阿托伐他汀10～20mg/d(平均13.65mg/d),治疗1年。对照组为87例同期在心血管病房住院的年龄及性别相匹配的其他患者。于入院时及随访1年后以数字式放射吸收测量法测定左手第2、3、4手指中节指骨的相对骨矿物质密度(BMD),并检测治疗前后血TC及LDL-C浓度。结果:1年后,治疗组患者血TC浓度降低25.86%[(5.22±0.97)mmol/L∶(3.87±0.42)mmol/L,P<0.01],LDL-C浓度均降低24.71%[(3.06±0.60)mmol/L∶(2.26±0.41)mmol/L,P<0.01],手指BMD增加5.78%[(0.588±0.061)g/cm2∶(0.622±0.046)g/cm2,P<0.01]。对照组患者血TC浓度[(4.37±1.03)mmol/L∶(4.67±0.49)mmol/L]及LDL-C浓度[(2.61±0.61)mmol/L∶(2.74±0.26)mmol/L,均差异无统计学意义,P>0.05],手指BMD降低0.13%[(0.596±0.062)g/cm2∶(0.585±0.047)g/cm2,P>0.05]。1年后BMD的变化2组相比差异有统计学意义(5.78%∶-0.13%,P<0.01)。结论:常规剂量的阿托伐他汀治疗降低血胆固醇水平的同时能增加老年冠心病患者BMD,改善患者的骨质疏松。
Objective: To investigate the effect of routine dose of atorvastatin on bone mineral density in elderly patients with coronary heart disease. Methods: Ninety-four patients with coronary heart disease diagnosed by coronary angiography were treated with atorvastatin 10 ~ 20mg / d (average 13.65mg / d) for 1 year according to the plasma LDL-C level. The control group consisted of 87 patients with other age-matched and gender-matched patients hospitalized in cardiovascular ward over the same period. At admission and one year after follow-up, the relative BMD of the middle phalanges of the second and third finger of the left hand was measured by digital absorption spectrometry. The levels of TC and LDL-C in the blood were measured before and after treatment. Results: After one year, the concentration of TC in the treatment group decreased by 25.86% [(5.22 ± 0.97) mmol / L, 3.87 ± 0.42 mmol / L, P <0.01] ± 0.60) mmol / L: (2.26 ± 0.41) mmol / L, P <0.01]. The BMD of the finger increased by 5.78% [(0.588 ± 0.061) g / cm2:(0.622 ± 0.046) g / cm2, P <0.01]. The levels of TC in the control group [(4.37 ± 1.03) mmol / L vs (4.67 ± 0.49) mmol / L and LDL-C concentrations [2.61 ± 0.61 mmol / L to The difference was not statistically significant (P> 0.05). The BMD of finger decreased by 0.13% (0.596 ± 0.062) g / cm2 (0.585 ± 0.047) g / cm2, P> 0.05. The difference of BMD after 1 year was statistically significant between the two groups (5.78%: -0.13%, P <0.01). CONCLUSIONS: Conventional doses of atorvastatin reduce blood cholesterol levels and increase BMD in elderly patients with coronary artery disease, improving osteoporosis in patients.