薛江义等

[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

[中图分类号] R591.4 [文献标识码] A [文章编号] 2095-0616（2014）10-20-04

[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）gavage for 8 weeks； （C）alendronate 0.5mg/（kg·d） gavage for 8 weeks；（D）simvastatin 20mg/（kg·d）gavage 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 witn 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.endprint

[Key words] Bisphosphonates；Alendronate；Simvastatin；Osteoporosis；Fracture healing

骨质疏松症（osteoporosis）是由多种原因引起的骨脆性增加、骨强度降低从而易于骨折的代谢性骨病。目前骨质疏松已成为危害中、老年人健康的主要疾病之一[1]。骨折是骨质疏松症的主要并发症。……