摘要
目的观察鲑鱼降钙素联合阿仑膦酸钠对老年骨质疏松的疗效以及探讨其影响骨代谢的调控机制。方法将本院收治的60例伴有疼痛症状的老年骨质疏松患者,计算机随机分为2组,对照组27例,治疗组33例,对照组口服阿仑膦酸钠70mg/次/周,治疗组在对照组治疗基础上注射鲑鱼降钙素,50 IU/次,每天,连续7d,第8 d开始以同等剂量隔天注射,第14 d开始同等剂量2次/周,28 d为一个疗程,共6个疗程,检测治疗前后患者疼痛症状、骨密度、血清1,25-(OH)2D3和PTH水平的变化情况。结果 1两组治疗后腰背痛量化结果均有一定程度的改善;与对照组比较,治疗组VAS等级综合评分显著下降,差异有统计学意义(P<0.05),对照组腰背痛VAS等级综合评分均>5,而治疗组评分均<4;2两组治疗后第1-4腰椎(L1-L4)和股骨颈、总髋部的骨密度与治疗前相比均具统计学差异(P<0.05),其中治疗组治疗后骨密度远高于对照组(P<0.05);对照组与治疗组在治疗后的T值均显著高于治疗前(P<0.05),且治疗组显著高于对照组(P<0.05);3治疗后对照组患者血清1,25-(OH)2D3水平明显低于治疗组(P<0.05),对照组血清PTH含量明显高于治疗组(P<0.05)。结论骨质疏松发生发展过程中伴有腰背疼痛,骨密度降低,鲑鱼降钙素联合阿仑膦酸钠可能通过增加1,25-(OH)2D3,抑制PTH的合成来改善骨质疏松症状。
Objective To observe the efficacy of salmon calcitonin combined with alendronate sodium on the treatment of senile osteoporosis and to explore its mechanism of regulation of bone metabolism. Methods Sixty elderly patients with osteoporosis were divided into two groups,27 cases in the control group and 33 cases in the treatment group. The patients in control group received 70 mg alendronate per day. The patients in the treatment group received intramuscular injection of 50 IU / day salmon for 7days,and every other day from the eighth day,and twice weekly from the fourteenth day,besides the alendronate treatment. One treatment course was 28 days,and the treatment lasted for 6 courses. The pain symptom before and after treatment,bone mineral density（ BMD）,serum 1,25-（ OH）2D3,and PTH were detected. Results 1） The back pain in patients of both groups relieved after the treatment. Comparing to that in control group（ VAS〉 5）,VAS in the treatment group（ VAS〈 4） decreased significantly（ P〈0. 05）. 2） After the treatment,BMD of the lumbar spine（ L1-L4）,femoral neck,and total hip was different comparing to that before the treatment in both groups（ P〈0. 05）. BMD was much higher in the treatment group than that in control group（ P〈0. 05）. T value after the treatment was significantly higher than that before the treatment in both groups,and it was higher in the treatment group than in control group. 3） After the treatment,serum 1,25-（ OH）2D3was significantly lower in control group than in the treatment group,but PTH content was significantly higher in control group（ P〈0. 05）. Conclusion The back pain and decrease of BMD occur during the development process of osteoporosis. Salmon calcitonin combined with alendronate sodium relieves the symptom of osteoporosis by increasing 1,25-（ OH）2D3and inhibiting PTH synthesis.
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2015年第7期835-839,共5页
Chinese Journal of Osteoporosis
基金
军区医药卫生科研基金(12MA071)
