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目的高血压患者体内钙代谢异常,本文探讨老年男性高血压患者骨密度的变化。方法新诊断高血压37例,正常血压21例,测定两组血脂、血糖、血钙、血磷、碱性磷酸酶(ALP)、肌酐、骨钙素和甲状旁腺素全段(i-PTH),用双能X线骨密度仪测定腰椎(L2～4)正位、股骨颈、大转子及Ward三角骨密度。结果老年男性高血压组L2～4正位平均骨密度、股骨颈、大转子及Ward三角骨密度均降低[L2～4正位平均骨密度,高血压(0.845±0.127)比正常血压(0.941±0.207)g/cm2;股骨颈骨密度,高血压(0.688±0.073)比正常血压(0.770±0.123)g/cm2;大转子骨密度,高血压(0.589±0.075)比正常血压(0.688±0.142)g/cm2;Ward三角骨密度,高血压(0.462±0.107)比正常血压(0.522±0.106)g/cm2;均P<0.05]。老年男性高血压组i-PTH升高[(53.1±17.8)比正常血压(41.1±13.6)ng/L,P<0.05],骨钙素差异无统计学意义(P>0.05)。L2～4正位骨密度平均值与收缩压呈负相关(r=-0.476,P<0.05)。结论老年男性高血压患者骨密度降低可能与高血压有关。
Objective To investigate the changes of bone mineral density (BMD) in elderly hypertensive patients. Methods Thirty-seven cases of newly diagnosed hypertension and 21 cases of normal blood pressure were enrolled in this study. Serum lipids, blood glucose, serum calcium, phosphorus, alkaline phosphatase (ALP), creatinine, osteocalcin and parathyroid hormone ), BMD of lumbar spine (L2 ~ 4), femoral neck, greater trochanter and Ward triangle were measured by dual energy X-ray absorptiometry. Results The average BMD of L2-4, the femoral neck, the greater trochanter and the Ward triangle in elderly hypertensive group were lower than those of the normal group (L2-4 orthophoria, 0.845 ± 0.127 vs 0.941 ± 0.207) g / cm 2; BMD of femoral neck, hypertension (0.688 ± 0.073) was higher than that of normotensive (0.770 ± 0.123) g / cm 2; BMD of tibia, hypertension (0.589 ± 0.075) g / cm2; Ward triangular bone mineral density, hypertension (0.462 ± 0.107) than normal blood pressure (0.522 ± 0.106) g / cm2; all P <0.05]. Compared with normal blood pressure (41.1 ± 13.6) ng / L, P <0.05], there was no significant difference in osteocalcin among elderly male hypertensive patients (P> 0.05). The mean L2 ~ 4 BMD was negatively correlated with SBP (r = -0.476, P <0.05). Conclusion The decrease of bone mineral density may be related to hypertension in elderly male hypertensive patients.