摘要
目的 探讨胰岛素联合唑来膦酸治疗老年糖尿病合并骨质疏松病人的疗效。 方法 选取2016年1月至2017年1月我院内分泌科确诊并接受治疗的老年糖尿病合并骨质疏松病人192例,随机分成对照组和观察组,每组各96例。对照组采用伏格列波糖联合唑来膦酸治疗,观察组采用胰岛素联合唑来膦酸治疗。治疗2个月后,检测2组病人治疗前后血糖、骨相关指标、骨密度,并对视觉模拟评分(VAS评分)、慢性微血管并发症等方面进行评估。 结果 治疗后,对照组病人仅血磷(P)、血钙(Ca)水平显著高于治疗前(P<0.05),空腹血糖(FPG)、骨特异性碱性磷酸酶(BAP)、骨钙素(BGP)、抗酒石酸酸性磷酸酶-5b(TRAP-5b)及Ⅰ型胶原C末端肽(s-CTX)水平无明显变化(P>0.05);观察组FPG、P、BGP、TRAP-5b、s-CTX水平均显著优于治疗前及对照组,差异有统计学意义(P<0.05)。治疗后,2组病人各部位骨密度、VAS评分均得到改善,且观察组上述指标均显著优于对照组,差异有统计学意义(P<0.05)。治疗后,观察组视网膜病变发病率明显低于对照组,差异有统计学意义(P<0.05)。 结论 采用胰岛素联合唑来膦酸治疗老年糖尿病合并骨质疏松病人,有利于维持病人骨代谢平衡,改善临床症状,效果显著,值得临床推广。
Objective To investigate the efficacy of insulin combined with zoledronic acid in the treatment of elderly diabetic patients with osteoporosis. Methods A total of 192 elderly patients with diabetes mellitus complicated with osteoporosis diagnosed and treated in Department of Endocrinology of Baoding Second Hospital from January 2016 to January 2017 were selected. They were randomly divided into control group and experimental group, with 96 cases in each group. Patients in control group were treated with voglibose combined with zoledronic acid. Patients in observation group were treated with insulin combined with zoledronic acid. Fasting plasma glucose ( FPG), bone-related indexes, bone mineral density, visual analogue scale ( VAS) score and chronic microvascular complications were observed before and after treatment. Results After treatment, the levels of blood phosphorus (P) and calcium (Ca) in the control group were significantly higher than those before treatment (P<0. 05), however, FPG, bone-specific alkaline phosphatase (BAP), osteocalcin (BGP), tartrate-resistant acid phosphatase-5b ( TRAP-5b) and type Ⅰ collagen C-terminal peptide ( s-CTX) had no significant changes (P>0. 05);The levels of FPG, P, BGP, TRAP-5b, s-CTX in the observation group were significantly improved than those before treatment and the control group (P<0. 05). After treatment, the bone mineral density and VAS scores of the two groups were improved significantly, and the indexes in the observation group were significantly better than those in the control group ( P< 0. 05). After treatment, the incidence rate of retinopathy in the observation group was significantly lower than that in the control group (P<0. 05). Conclusions The combination treatment of insulin and zoledronic acid is beneficial to maintain the balance of bone metabolism and improve the clinical symptoms in senile diabetes mellitus patients with osteoporosis.
作者
卢燕
王晶璞
刘莉红
LU Yan;WANG Jing-pu;LIU Li-hong(Department of Endocrinology, the NO.2 Hospital of Baoding, Baoding 071051, China;Department of Nuclear Medicine, the NO.2 Hospital of Baoding, Baoding 071051, China)
出处
《实用老年医学》
CAS
2019年第6期565-568,共4页
Practical Geriatrics
关键词
胰岛素
唑来膦酸
糖尿病
骨质疏松
疗效
insulin
zoledronic acid
diabetes mellitus
osteoporosis
efficacy
