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背景国外研究发现β受体阻滞剂有调节动物骨代谢,促进骨形成,抑制骨吸收作用。而长期服用β受体阻滞剂对人骨代谢影响的临床资料则非常有限。目的观察长期服用β受体阻滞剂美托洛尔对老年男性原发性高血压患者骨质密度及骨折发生率的影响。方法随机连续选择年龄在60～70岁的老年男性原发性高血压患者130例,分为对照组51例(未服用β受体阻滞剂),治疗组79例(美托洛尔,25～50mg,2次/d)连续服用美托洛尔3年。分别比较组间:①血清钙、磷浓度、碱性磷酸酶浓度;②骨密度;③骨折发生率。结果β受体阻滞剂治疗的病人血钙、血磷浓度,碱性磷酸酶浓度与对照病人各相应数据比较,差异均无统计学意义(P>0.05);β受体阻滞剂用药后骨密度明显增加[治疗组用药前(1.05±0.19)g/cm2比用药后骨密度(1.39±0.25)g/cm2,P<0.05];β受体阻滞剂比较治疗组骨密度[(1.39±0.25)g/cm2]较对照组骨密度[(1.09±0.21)g/cm2]明显增高(P<0.05),骨折发生率(3.8%)与对照组(9.8%)比较有下降趋势,但无统计学意义(P>0.05)。结论长期服用治疗剂量β受体阻滞剂美托洛尔的老年男性原发性高血压患者,骨密度明显增高,骨折发生率有下降趋势,但血清钙代谢没有受到影响。
Background Foreign studies have found that beta blockers regulate bone metabolism in animals, promote bone formation and inhibit bone resorption. The long-term use of β-blockers on the impact of human bone metabolism in clinical data is very limited. Objective To observe the effects of metoprolol, a long-term β-blocker, on the bone density and the incidence of fractures in elderly patients with essential hypertension. Methods A total of 130 elderly hypertensive patients aged 60 ~ 70 years were randomly divided into control group (n = 51) (without beta blocker) and treatment group (metoprolol, 25 ~ 50mg, 2 times / d) taking metoprolol continuously for 3 years. Respectively between groups: ① serum calcium, phosphorus concentration, alkaline phosphatase concentration; ② bone mineral density; ③ fracture incidence. Results There was no significant difference in serum calcium, serum phosphorus and alkaline phosphatase between the patients treated with β-blocker and the corresponding data of the control patients (P> 0.05). After the β-blockers were administered BMD was significantly increased in the treatment group (1.05 ± 0.19 g / cm 2 vs 1.39 ± 0.25 g / cm 2, P <0.05); β-blocker treatment compared BMD in the treatment group [(1.39 ± 0.25) g / ± 0.25) g / cm2] compared with the control group (1.09 ± 0.21 g / cm2) (P <0.05). The incidence of fractures (3.8%) showed a downward trend compared with that of the control group No statistical significance (P> 0.05). Conclusion Long-term treatment of patients with metoprolol, a long-term dose of beta-blocker metoprolol, significantly increases bone mineral density and fractures, but serum calcium metabolism is not affected.