摘要
目的:观察联合维生素D和第三代二膦酸盐对糖皮质激素长期应用所造成的骨量丢失肾炎患者的疗效。方法:15例来自本院经定量CT(QCT)诊断为糖皮质激素性骨质疏松和骨量减少病情稳定肾炎患者,服用钙尔奇1片/d和福善美70mg/周,观察入选时及治疗6月后临床症状和空腹血钙、磷、甲状旁腺激素、碱性磷酸酶、24h尿钙、磷和定量CT腰椎骨密度值变化。结果:疼痛症状改善总有效率(显效加有效)为53.3%。治疗6个月前后血钙、磷、甲状旁腺激素、碱性磷酸酶、24h尿钙、磷变化,无统计学意义(P>0.05),腰椎骨密度差值为(11.8±5.3)mg/cm3,经检验有统计学意义(P<0.01)。结论:维生素D联合二膦酸盐能有效改善糖皮质激素长期应用所造成的骨量丢失,增加骨密度,改善疼痛,有利于最大程度的预防骨质疏松骨折,但是否优于传统单纯钙和维生素D治疗有待进一步对照研究。
Objective：To observe the effects of combined bisphosphonates and vitamin D therapy on glucocorticoid induced bone mineral content loss.Methods：15 stable nephritic patients diagnosed of glucocorticoid induced osteoporosis and osteopenia by quantitative CT（QCT） were included in the study. Caltrate （one tablet per day） plus alendronate（70 mg per week） were administered to the patients.The bone mineral density,pain symptoms and biochemical parameters,including serum calcium and phosphorus,parathyroid hormone（PTH）,alkaline phosphatase（AKP）,24 hours urine calcium and phosphorus,were detected before and after 6 months of treatment.Results：the total rate of pain relief was 53.3%. The change of biochemical parameters were not statistically significant（P〉0.05）, lumber vertebra bone mineral density increased significantly （P〈0.01） by （11.8±5.3）mg/cm3.Conclusion：Combination therapy of bisphosphonates and vitamin D can ameliorate the long-term bone mineral content loss induced by glucocorticoid, increase bone mineral density, relieve pain, and prevent osteoporosis fracture to a greater extent. Further study is needed to explore whether it is superior to traditional vitamin D and calcium.
出处
《中国中西医结合肾病杂志》
2008年第1期36-38,共3页
Chinese Journal of Integrated Traditional and Western Nephrology
