摘要
目的观察阿法骨化醇和阿仑膦酸钠合用对绝经后骨质疏松症患者血清骨代谢标志物的影响。方法选取386例绝经后骨质疏松症患者,随机分为两组,各193例。对照组予阿仑膦酸钠片,70 mg/次,1次/周;试验组在对照组基础上加用阿法骨化醇胶丸,0.5μg/次,1次/d,连续治疗24个月。比较两组患者治疗前与治疗后6、12、18、24个月时骨密度、疼痛程度、骨代谢标志物水平、折发生率及药物不良反应发生率。结果治疗前,两组骨密度和疼痛程度差异无统计学意义(P> 0.05);治疗后18个月和24个月,实验组的L2~4腰椎骨密度和股骨颈骨密度高于对照组,疼痛程度低于对照组,组间差异有统计学意义(P <0.05)。治疗前,两组骨代谢标志物差异无统计学意义(P> 0.05);治疗后18个月和24个月,试验组骨钙素(OC)和维生素D(Vit D)血清水平高于对照组,I型胶原联蛋白羧基末端肽(CTX)和甲状旁腺激素(PTH)血清水平低于对照组,组间差异有统计学意义(P <0.05)。2组不良反应发生率差异无统计学意义(P> 0.05),试验组骨折发生率低于对照组(P <0.05)。结论阿法骨化醇和阿仑膦酸钠合用利于改善绝经后骨质疏松症患者的骨代谢状态,对提高骨密度,预防骨折有积极作用。
Objective To observe the influence of alfacalciferol and alendronate on serum bone metabolism markers of postmenopausal osteoporosis patients.Methods Totally,386 cases of postmenopausal osteoporosis were randomly divided into two groups,with 193 cases in each.The patients in the control group were given alendronate tablets(70 mg/time,1 time/week),while the patients in the experimental group were given alfacalciferol pellets(0.5 g/time,1 time/day)on basis of the control group,and all the patients were treated for 24 months.The indexes of bone mineral density,pain level,bone metabolism marker levels before treatment and at 6,12,18 and 24 months after treatment were compared,the incidence of fracture and incidence of adverse drug reactions during the treatment were compared too.Results Before treatment,there was no statistical significance on the difference in bone mineral density and pain degree between the two groups(P>0.05).At 18 and 24 months after treatment,L2-4 lumbar vertebra density and femoral neck bone density in the experimental group were higher than those in the control group,and the pain degree was lower than that in the control group,and the difference between the groups was statistically significant(P<0.05).Before treatment,there was no statistical significance on the difference in bone metabolism markers between the two groups(P>0.05).At 18 month and 24 month after treatment,the serum osteocalcin(OC)and vitamin D(VitD)level of experimental group was higher than the control group,the serum type I collagen carboxyl terminal protein peptide(CTX)and parathyroid hormone(PTH)level were lower than the control group,and the differences between groups were statistically significant(P<0.05).There was no statistical significance on the difference in the incidence of adverse reactions between the two groups(P>0.05),and the incidence of fracture in the experimental group was lower than that in the control group(P<0.05).Conclusion The combination of alfacalciferol and alendronate could improve the bone metabolism
作者
程福平
洪盾
杨夏玲
CHENG Fu-ping;HONG Dun;YANG Xia-ling(Department of Orthopedics,Taizhou Hospital,Taizhou,Zhejiang 317000,China)
出处
《中国卫生检验杂志》
CAS
2020年第16期1978-1981,共4页
Chinese Journal of Health Laboratory Technology
