摘要
目的探讨骨吸收抑制剂阿仑膦酸钠对男性原发性骨质疏松症骨密度和骨转换生化指标的影响。方法2005年1月至2007年1月前瞻性纳入北京协和医院诊断的20例男性原发性骨质疏松症患者,以20名正常男性为对照。骨质疏松症患者每周服用阿仑膦酸钠70 mg,且每日服用钙尔奇D 1片,疗程为18个月。每6个月采用双能X线骨密度仪测量腰椎和股骨近段骨密度,每3个月测量骨形成指标碱性磷酸酶和骨吸收指标Ⅰ型胶原羧基末端肽。正常男性不予干预,研究开始时和18个月时检查腰椎和股骨近端骨密度。结果骨质疏松症组治疗前骨密度明显低于正常对照组。阿仑膦酸钠组治疗18个月时,与治疗前比较,腰椎、股骨颈、大转子、全髋和股骨干骨密度值增加6.3%、2.5%、5.8%、3.5%及4.2%(P均<0.05)。骨转换生化指标碱性磷酸酶(ALP)和CTX治疗6个月时即显著下降,此后维持在较低水平,治疗18个月后ALP降低33.6%,CTX下降66.7%(P均<0.01),骨吸收指标较骨形成指标下降更明显。患者对阿仑膦酸钠的耐受性良好。正常对照组骨密度和血ALP在18个月期间无明显变化。结论与对女性骨质疏松症患者疗效相似,阿仑膦酸钠能够明显增加男性原发性骨质疏松症患者的骨密度、降低骨转换生化指标,且安全性良好。
Objective Osteoporosis in men was relatively neglected. The aim of this study was to prospectively evaluate the effects of alendronate on bone mineral density （BMD） and bone turnover in primary osteoporosis in men. Methods 20 Chinese male patients diagnosed as untreated primary osteoporosis by Peking union medical college hospital and 20 normal men as control were recruited from 2005.1 to 2007.1. The osteoporotic men were treated with alendronate and caltrate. Normal men did not accept treatment. During a 18-month duration, serum alkaline phosphatase （ALP） and C-terminal telopeptidc of type Ⅰ collagen （CTX） levels were measured every 3 months,and BMD at lumbar spine and hip were measured by dual-energy X-ray absorptiometry every 6 months. Results BMD was significantly increased at the lumbar spine,femoral neck,trochanter,total hip and femoral shaft by 6. 3% ,2. 5% ,5.8% ,3.5% and 4. 2% after 18 months treatment of alendronate, compared with baseline （ P 〈 0. 05 ）. Both ALP and CTX levels were significantly decreased by 33.6% and 66. 7 % at 18 month （P 〈 0. 01 ）, and then they were within a stable low level from the 6th month of treatment in alendronate group. The tolerance of the patients to alendronate was quite well. In control group, BMD and ALP had no significant change during the observation period. Conclusion The beneficial effects of alendronate upon increasing BMD and reducing bone turnover markers in Chinese male patients with primary osteoporosis were confirmed, comparable to those previously reported in postmenopausal women with osteoporosis.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2009年第3期222-224,共3页
Chinese Journal of Practical Internal Medicine
基金
国家自然科学基金科学部主任基金(30440074)
