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目的探讨常用降压药培哚普利对原发性骨质疏松症(POP)伴高血压患者骨转换指标的改善作用。方法将90例确诊患者随机分为3组:培哚普利组(30例)服用培哚普利每日4 mg;阿仑膦酸钠组(30例)服用阿仑膦酸钠每周70 mg及苯磺酸氨氯地平每日5 mg;氨氯地平组(30例)服用苯磺酸氨氯地平每日5 mg。3组同时予调整生活方式和服用碳酸钙D3片(每日1片)作为基础措施。各组均受试6个月,受试前后检测骨转换指标抗酒石酸酸性磷酸酶(TRAP)、Ⅰ型胶原交联C末端肽(CTX)及骨特异性碱性磷酸酶(BALP)。结果氨氯地平组治疗后骨转换指标水平无改善,继续升高(P<0.05);培哚普利组及阿仑膦酸钠组骨转换指标水平降低,较治疗前改善明显(P<0.05)。虽培哚普利组改善程度不如阿仑膦酸钠组(P<0.05),但较氨氯地平组明显(P<0.05)。结论虽培哚普利效果不如阿仑膦酸钠,但服用培哚普利6个月仍可降低POP伴高血压患者的骨转换指标,对POP有早期改善作用,培哚普利有望成为POP伴高血压患者降压药物的优先选择。
Objective To investigate the effect of perindopril, a commonly used antihypertensive drug, on bone turnover in patients with essential osteoporosis (POP) and hypertension. Methods Ninety patients were randomly divided into 3 groups: perindopril group (30 cases) taking perindopril 4 mg daily; alendronate sodium group (30 cases) taking alendronate weekly 70 mg and amlodipine besylate daily 5 mg; amlodipine 30 patients treated with amlodipine besylate daily 5 mg. 3 groups to adjust lifestyle and take calcium D3 tablets (daily 1) as a basis for measures. Each group was tested for 6 months. TAP markers such as tartrate-resistant acid phosphatase (TRAP), collagen Ⅰ-C-terminal peptide (CTX) and bone specific alkaline phosphatase (BALP) were measured before and after the treatment. Results The level of bone turnover index did not improve after treatment with amlodipine group (P <0.05). The level of bone turnover index in perindopril group and alendronate group was significantly lower than that before treatment (P <0.05 ). Although the improvement of perindopril group was not as good as alendronate sodium group (P <0.05), it was more significant than that of amlodipine group (P <0.05). Conclusions Although perindopril is less effective than alendronate, perindopril 6 months can still reduce the bone turnover index in patients with POP accompanying hypertension and improve early on POP. Perindopril is expected to become POP High blood pressure patients with antihypertensive drugs preferred.