摘要
目的探讨老年女性骨质疏松症患者应用骨化三醇联合碳酸钙D_3片治疗的临床效果。方法老年女性骨质疏松症患者186例,随机分为对照组和观察组各93例,对照组仅口服碳酸钙D_3片600mg/次,1次/d;观察组在对照组治疗基础上口服骨化三醇,0.25μg/次,2次/d,连续6个月。治疗前及治疗6个月,2组采用ELISA法检测血清碱性磷酸酶(alkaline phosphatase,ALP)、血钙(calcium,Ca)、血磷(phosphorus,P)水平,采用视觉模拟评分(visual analogue scale,VAS)评估患者疼痛程度,骨密度测定仪检测股骨大转子处骨密度值,计算治疗总有效率,并记录治疗期间不良反应发生情况。结果观察组治疗前骨密度[(0.58±0.23)g/cm^2]、VAS评分[(4.62±1.37)分]与对照组[(0.56±0.11)g/cm^2、(4.81±2.96)分]比较差异均无统计学意义(P>0.05);治疗6个月,观察组、对照组骨密度[(0.72±0.25)、(0.63±0.53)g/cm^2]均高于治疗前,VAS评分[(2.13±0.98)、(3.67±1.83)分]均低于治疗前(P<0.05),且观察组较对照组变化明显(P<0.05);治疗6个月,观察组总有效率(96.77%)高于对照组(80.85%)(P<0.05);观察组治疗前血清ALP[(58.36±7.37)u/L]、Ca[(2.03±1.38)mmol/L]、P[(1.12±0.46)mmol/L]水平与对照组[(57.29±9.15)u/L、(2.15±1.93)mmol/L、(1.08±0.69)mmol/L]比较差异均无统计学意义(P>0.05);治疗6个月,观察组、对照组血清ALP[(79.62±11.83)、(70.23±8.56)u/L]、Ca[(2.87±2.06)、(2.36±1.98)mmol/L]、P[(1.39±0.38)、(1.21±0.51)mmol/L]水平均高于治疗前,且观察组高于对照组(P<0.05);治疗过程中,2组均无明显不良反应发生。结论骨化三醇联合碳酸钙D_3片治疗老年女性骨质疏松症效果良好,可有效改善钙、磷代谢,增加骨密度,减轻患者疼痛。
Objective To explore the clinical effect of calcitriol combined with calcium carbonate D3 tablets on elderly women with osteoporosis.Methods Totally 186 elderly female patients with osteoporosis were randomly divided into observation group and control group,with 93 patients in each group.Observation group was orally given calcitriol0.25μg per time,twice daily,and calcium carbonate D3 tablets 600 mg,once daily,while control group was only given calcium carbonate D3 tablets 600 mg,once daily,totally for 6 months.Before and after 6-month treatment,the levels of serum alkaline phosphatase（ALP）,calcium（Ca）and phosphorous（P）were detected by ELISA.Visual analogue scale（VAS）was used to assess the degree of pain and the densitometer was used to detect bone mineral density at larger femur.The total effective rate was calculated and the occurrence of adverse reactions was recorded during treatment.Results There were no significant differences in bone mineral density and VAS between observation group（（0.58±0.23）g/cm^2,4.62±1.37）and control group（（0.56±0.11）g/cm^2,4.81±2.96）before treatment（P〉0.05）.After6-month treatment,the bone mineral density was significantly higher in observation group（（0.72±0.25）g/cm^2）and control group（（0.63±0.53）g/cm^2）than that before treatment,the VAS score was significantly lower in observation group（2.13±0.98）and control group（3.67±1.83）than that before treatment（P〈0.05）,and the change of each index was more obvious in observation group（P〈0.05）.The total effective rate was significantly higher in observation group（96.77%）than that in control group（80.85%）after 6-month treatment（P〈0.05）.There were no significant differences in the levels of serum ALP（（58.36±7.37）u/L vs（57.29±9.15）u/L）,Ca（（2.03±1.38）mmol/L vs（2.15±1.93）mmol/L）and P（（1.12±0.46）mmol/L vs（1.08±0.69）mmol/L）between observation group and control group before treatment（P〉0.05）.After 6-month treatm
作者
戴蓉芳
冯月英
乔红梅
施惠华
曹国良
DAI Rong-fang;FENG Yue-ying;QIAO Hong mei;SHI Hui-hua;CAO Guo liang(Department of Geriatrics, the Ninth People＇s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China)
出处
《中华实用诊断与治疗杂志》
2018年第7期678-680,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
上海市科学技术委员会科研计划项目(13DZ1941606)
