阿仑膦酸钠和骨化三醇对绝经后女性糖尿病伴骨质疏松症患者动脉硬化的影响

目的:探讨阿仑膦酸钠结合骨化三醇对绝经后女性2型糖尿病伴骨质疏松症(OP)患者的动脉粥样硬化的影响。方法:绝经后女性2型糖尿病患者48例,行双侧颈动脉彩色多普勒检查,并进行各项生化指标检测。研究对象被分为OP组(23例)与非骨质疏松对照(NOP)组(25例),OP组给予阿仑膦酸钠每周一片(70mg)结合骨化三醇(0.25μg/d),为期12个月。结果:治疗前OP组颈动脉内膜中厚度[IMT,(0.88±0.16)mm:(0.78±0.11)mm]和动脉粥样斑块积分[PS,(0.78±0.16):(0.52±0.15)]显著高于NOP组(P均0.05)。治疗后,OP组IMT和PS与治疗前比较无显著性改变,而NOP组IMT[(0.85±0.87)mm:(0.78±0.11)mm]和PS[(0.63±0.08):(0.52±0.15)]均显著增加(P均0.05)。OP组动脉粥样硬化进展率[IMT(21.74%:52.0%),PS(30.43%:72.0%),P均0.05]显著低于NOP组(P0.05)。结论:绝经后女性2型糖尿病合并骨质疏松症患者的动脉粥样硬化程度较无骨质疏松患者高。阿仑膦酸钠结合骨化三醇的治疗可以延缓绝经后女性2型糖尿病合并骨质疏松患者的动脉粥样硬化进展。

Effects of alendronate combined with calcitriol on atherosclerosis in postmenopausal women accompanied with type 2 diabetes and osteoporosis

Objective：To investigate the effects of alendronate combined with calcitriol on progression of atherosclerosis in postmenopausal women accompanied with type 2 diabetes and osteoporosis（OP）.Methods：A total of 48 postmenopausal women with type 2 diabetes and OP were enrolled in this study.They were divided into OP group（n=23） and non-osteoporosis control group（NOP group,n=25）.They were examined with biochemistry tests and carotid color Doppler ultrasonography.Alendronate（70mg weekly） and calcitriol（0.25μg/d） were given to OP group for a year.Results：Patients with OP had significantly higher intima-media thickness and plaque score than those of NOP group before treatment（P〈0.05 both）.After 12-month treatment,IMT and PS in the OP group were not significantly changed,whereas both parameters in NOP group were significantly increased compared with before treatment.The progress rates of IMT（21.74%）and PS（30.43%） of OP group were significantly lower than those of NOP group（IMT 52.0%,PS 72.0%,P〈0.05 all）.Conclusion：Atherosclerosis parameters（IMT and PS）level in postmenopausal women with type 2 diabetes and osteoporosis are higher than those of patients without osteoporosis.Alendronate combined calcitriol therapy might protect from against progressive atherosclerosis.