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目的:探讨运用锝(99 Tc)亚甲基二磷酸盐注射液联合辛伐他汀治疗类风湿关节炎继发骨质疏松临床疗效。方法:选取我院2012年-2013年住院部明确诊断为类风湿关节炎(RA)继发骨质疏松(OP)患者106例,随机分为4组:对照组采取2种及以上慢作用抗风湿药物(如甲氨喋呤、来氟米特、柳氮磺氨吡啶、硫酸羟氯喹、白芍总苷等)治疗,同时采用口服钙剂及活性维生素D3,治疗1组在对照组基础上加用锝(99 Tc)亚甲基二磷酸盐注射液及口服辛伐他汀治疗;治疗2组在对照组基础上加用锝(99 Tc)亚甲基二磷酸盐注射液治疗,治疗3组在对照组基础上加用辛伐他汀治疗。总疗程6个月。观察治疗前后骨密度(桡-BMD、腰-BMD)、骨合成指标(ALP)、C反应蛋白(CRP)、类风湿因子(RF)、血沉(ESR)、血脂、血钙、血磷、肝肾功能等相关指标。结果:治疗6个月后显示,治疗1组患者BMD显著增加,ALP显著改善,治疗前后比较差异有统计学意义(P<0.05),优于治疗2、3组,且治疗2组优于治疗3组。对照组治疗后BMD、ALP指标较前改善,但差异无统计学意义(P>0.05)。4组治疗前后RF、CRP、ESR等指标明显下降,差异有统计学意义(P<0.05)。结论:锝(99 Tc)亚甲基二磷酸盐注射液联合辛伐他汀能显著增加RA患者BMD,明显改善患者的OP,提高患者生活质量。
Objective: To investigate the clinical efficacy of technetium (99 Tc) methylene diphosphate injection combined with simvastatin in the treatment of rheumatoid arthritis secondary to osteoporosis. Methods: A total of 106 patients with rheumatoid arthritis (RA) secondary osteoporosis (OP) who were diagnosed as rheumatoid arthritis (RA) from 2012 to 2013 in our hospital were randomly divided into 4 groups: the control group received 2 or more slow-acting anti-osteoporosis Rheumatic drugs (such as methotrexate, leflunomide, sulfasalazine, hydroxychloroquine sulfate, total glucosides of paeony), while using oral calcium and vitamin D3, the treatment group 1 on the basis of the control group Plus technetium (99 Tc) methylene diphosphate injection and oral simvastatin treatment; treatment group 2 in the control group based on the addition of technetium (99 Tc) methylene diphosphate injection treatment of three groups In the control group plus simvastatin treatment. The total course of 6 months. BMD, ALP, CRP, rheumatoid factor (RF), ESR, blood lipid, blood calcium, phosphorus and liver before and after treatment were observed. Renal function and other related indicators. Results: Six months after treatment, BMD in treatment group 1 was significantly increased and ALP was significantly improved (P <0.05), which was better than treatment groups 2 and 3, and treatment group 2 was better than treatment group 3 groups. After treatment, the BMD and ALP indexes of the control group improved, but the difference was not statistically significant (P> 0.05). The indexes of RF, CRP and ESR in the 4 groups before and after treatment decreased significantly, with significant difference (P <0.05). CONCLUSION: Technetium (99 Tc) methylene diphosphate injection combined with simvastatin can significantly increase BMD in patients with RA, significantly improve the patient’s OP and improve the quality of life of patients.