【摘要】 目的探讨辛伐他汀联合阿法骨化醇对类风湿关节炎(rheumatoid arthritis,RA)患者骨密度(bonemineral density,BMD)的影响。方法选择103例RA伴骨质疏松(osteoporosis,OP)患者,随机分为治疗组(52例)和对照组(51例)。治疗组给予常规2种改善病情抗风湿药(disease modifying antirheumatic drugs,DMARD)加辛伐他汀20 mg/d、阿法骨化醇0.25μg/d口服。对照组2种DMARD药物联合阿法骨化醇0.25μg/d治疗。治疗周期6个月。比较2组患者治疗前、后血清总胆固醇(total cholesterin,TC)、低密度脂蛋白胆固醇(low densitylipoprtein cholesterin,LDL-C)、碱性磷酸酶(alkaline phosphatase,ALP)、C-反应蛋白(C-reactive protein,CRP)和类风湿因子(rheumatism factor,RF)等指标。比较患者治疗前后腰椎和桡骨远端BMD变化。结果治疗6个月后显示,辛伐他汀治疗组患者骨合成指标ALP较治疗前有明显降低,腰椎和桡骨BMD较治疗前增加,差异有统计学意义(P<0.05),与对照组比较BMD增加显著,差异有统计学意义(P<0.05)。对照组患者治疗后ALP、BMD变化差异均无统计学意义(P>0.05)。结论辛伐他汀能增加RA患者BMD,改善患者的OP。更多还原

【Abstract】 Objective To observe the effect of simvastatin and alpha-D3(a-D3) on the levels of bone mineral density ( BMD) in rheumatoid arthritis patients.Methods A total of 103 rheumatoid arthritis patients with osteoporosis (OP) were divided into two groups.In the treatment group,there were 52 patients who were treated with the two routine disease modifying antirheumatic drugs (DMARD),simvastatin (20 mg/d) and a-D3(0.25 μg/d).In the control group,there were 51 patients who were treated with the two routine DMARD and a-D3 (0.25 μg/ d).After 6 months treatment,the levels of blood total cholesterin (TC),low density lipoprotein cholesterin(LDL-C) ,alkaline phosphatase( ALP),rheumatism factor(RF) and C-reactive protein (CRP) were compared.The levels of BMD of lumbar and distal radius were compared pre- and post-treatment.Results After 6 months,in the treatment group,the levels of ALP post-treatment were significantly lower than those of pretreatment ( P <0.05),the BMD of lumbar and distal radius post-treatment were significantly increased than those of pretreatment ( P <0.05),the BMD of post-treatment in the treatment group were significantly increased than control group. While there was no significant difference between pretreatment and posttreatment in control group(P >0.05). Conclusion Simvastatin can increase the levels of BMD and modify OP in rheumatoid arthritis patients.更多还原