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阿仑膦酸钠联合辛伐他汀对骨质疏松骨折的影响
引用本文:薛江义,张晶晶,卢向东,徐彬.阿仑膦酸钠联合辛伐他汀对骨质疏松骨折的影响[J].中国医药科学,2014(10):20-23.
作者姓名:薛江义  张晶晶  卢向东  徐彬
作者单位:山西医科大学第一医院骨科;山西医科大学第一医院内分泌科;
摘    要:目的通过实验观察阿仑膦酸钠联合辛伐他汀对骨质疏松大鼠骨折愈合的影响。方法成年雌性SD大鼠50只,随机分为5组:(A)假手术对照组;(B)去势对照组;(C)去势阿仑膦酸钠组;(D)去势辛伐他汀组;(E)去势联合用药组。B、C、D、E组行双侧卵巢切除术,A组仅切除部分脂肪组织。8周后每组随机选取2只大鼠确认骨质疏松造模成功后,各组均行左侧股骨中段骨折,并使用克氏针髓内固定。骨折内固定术后予以下药物干预:A、B两组:生理盐水5mL/(kg·d)灌胃8周;C组:阿仑膦酸钠0.5mg/(kg·d)灌胃8周;D组:辛伐他汀20mg/(kg·d)灌胃8周;E组阿仑膦酸钠0.5mg/(kg·d)+辛伐他汀20mg/(kg·d)灌胃8周。所有大鼠处死后收集血样和左侧股骨,进行血钙、磷、碱性磷酸酶含量、股骨X线骨密度及生物力学强度检测。结果卵巢去势组对比假手术对照组骨密度有明显减少,血清碱性磷酸酶水平升高,血钙、磷变化无统计学意义;使用阿仑膦酸钠及联合辛伐他汀治疗8周后,血钙、磷变化无统计学意义,碱性磷酸酶降低,股骨骨密度、生物力学功能获得改善,其中联合用药组更为明显,差异有统计学意义。结论阿仑膦酸钠有助于骨质疏松骨折愈合后生物力学功能的恢复,其中辛伐他汀可起到协同作用。

关 键 词:双膦酸盐  阿仑膦酸钠  辛伐他汀  骨质疏松  骨折

Impact of alendronate combined with simvastatin on osteoporotic fractures
XUE Jiangyi,ZHANG Jingjing,LU Xiangdong,XU Bin.Impact of alendronate combined with simvastatin on osteoporotic fractures[J].China Medicine and Pharmacy,2014(10):20-23.
Authors:XUE Jiangyi  ZHANG Jingjing  LU Xiangdong  XU Bin
Affiliation:1.Department of Orthopaedics,Shanxi Medical University First Hospital,Taiyuan 030001,China;2.Department of Production, Shanxi Medical University First Hospital,Taiyuan 030001,China )
Abstract:Objective To investigate the effects of alendronate combined with simvastatin on the osteoporotic fracture healing in rats. Methods 50 SD adult female rats were randomly divided into 5 groups: ( A ) sham operation control group;(B)ovariectomized control group;(C)ovariectomized alendronate group;(D)simvastatin group;(E) ovariectomized alendronate and simvastatin group.B, C, D,Egroup underwent ovariectomy surgery,A group only partially excised adipose tissue.8 weeks later,2 rats were selected randomly from each group to confirm osteoporosis successful modeling.Then the midshaft femur fracture model was established by an operation and intramedullary nails fixation was achieved with Kirschner wire.Deal each group of rats with such drug intervention as follows:(A,B) physiological saline 5mL/ ( kg · d ) garage for 8 weeks; (C)alendronate 0.Stag/ ( kg ·d ) garage for 8 weeks;(D) simvastatin 20mg/ ( kg· d ) garage for 8 weeks (E) alendronate 0.5mg/ ( kg · d ) + simvastatin 20mg/ ( kg · d ) gavage for 8 weeks.All the rats were killed and their blood samples and left femurs were collected.The serum calcium, phosphorus,alkaline phosphatase(ALP)content,X-ray bone mineral density(BMD) and biomechanical strength were detected. Results Compared with the sham group,the ovariectomized group had significantly reduced bone mineral density,elevated ALP level and serum calcium,phosphorus content had no significant change.After treatment with alendronate and simvastatin for 8 weeks,calcium,phosphorus content had no significant change; alkaline phosphatase level decreased;femoral bone mineral density and biomechanical strength were improved.This result is more obvious in alendronate and simvastatin group, the difference was statistically significant. Conclusion Alendronate is beneficial to the restoration of biomechanical function in the osteoporosis fracture healing,and simvastatin can play a synergistic effect.
Keywords:Bisphosphonates  Alendronate  Simvastatin  Osteoporosis  Fracture healing
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