摘要
目的探讨妊娠哺乳相关骨质疏松症(pregnancy and lactation-associated osteoporosis,PLO)经双膦酸盐治疗的效果,以期为此类患者提供可选择的治疗方案。方法以青岛大学附属医院收治的3例PLO患者为研究对象,均表现为重度骨质疏松及不同程度的椎体压缩性骨折,均给予补充钙、活性维生素D治疗。观察患者采用双膦酸盐治疗后临床症状及骨密度(bone mineral density,BMD)变化情况,并结合相关文献分析讨论。结果病例1于产后15个月诊断为PLO并接受唑来膦酸(密固达)静脉用药,1年后临床症状缓解不明显,给予口服阿仑膦酸钠维生素D3(福美加)治疗3个月后症状缓解,2年后随访腰椎BMD增加37.02%,股骨颈BMD增加6.97%,全髋BMD增加7.74%;病例2于产后6个月诊断为PLO并接受唑来膦酸(密固达)静脉用药,6个月后临床症状缓解,11个月后腰椎BMD增加16.6%,股骨颈BMD增加9.12%,全髋BMD增加13.34%;病例3于产后9个月接受唑来膦酸(密固达)静脉用药,6个月后临床症状较前缓解,腰椎BMD增加15.86%,股骨颈BMD增加3.13%,全髋BMD增加11.09%。结论双膦酸盐治疗PLO可明显改善临床症状、提高BMD。加深对PLO的认识,做到早诊断早治疗,对提高临床治疗效果大有裨益。
Objective To explore the effects of bisphosphonate treatment on pregnancy and lactationassociated osteoporosis(PLO)in order to provide an effective treatment for patients with PLO.Methods Three patients with PLO admitted to the Affiliated Hospital of Qingdao University were selected as subjects.All patients presented with severe osteoporosis and different degrees of vertebral compression fractures.They were all treated with calcium supplementation and vitamin D3.The clinical symptoms and bone mineral density(BMD)changes of patients were observed after bisphosphonate treatment,and relevant literature was analyzed.Results Case 1 was diagnosed with PLO15 months after delivery and received infusion of zoledronic acid intravenously.After 1 year,the clinical symptoms were not significantly relieved.Next,alendronate and vitamin D3 tablets were given for 3 months,and the symptoms relieved.After 2 years of follow-up,BMD at the lumbar spine increased by 37.02%,BMD at the femoral neck increased by 6.97%,and BMD at the total hip increased by 7.74%.Case 2 was diagnosed with PLO 6 months after delivery and received zoledronic acid infusion.The clinical symptoms relieved after 6 months.After 11 months,the BMD at the lumbar spine increased by 16.6%,the BMD at the femoral neck increased by 9.12%,and BMD at the total hip increased by 13.34%.Case 3 received zoledronic acid infusion 9 months after delivery.After 6 months of treatment,the clinical symptoms were relieved,the BMD at the lumbar spine increased by 15.86%,the BMD at the femoral neck increased by 3.13%,and BMD at the total hip increased by 11.09%.Conclusion Bisphosphonate treatment can significantly improve clinical symptoms and increase BMD of patients with PLO.Early diagnosis and treatment of PLO is of great benefit to improve the treatment effects.
作者
张欣欣
张英智
袁鹰
董冰子
孔悠然
赵文娟
付正菊
王颜刚
孙晓方
ZHANG Xin-xin;ZHANG Ying-zhi;YUAN Ying;DONG Bing-zi;KONG You-ran;ZHAO Wen-juan;FU Zheng-ju;WANG Yan-gang;SUN Xiao-fang(Department of Endocrinology and Metabolism,The Affiliated Hospital of Qingdao University,Qingdao,Shandong 266000,China;Department of Endocrinology,Qingdao No.9 People s Hospital,Qingdao,Shandong 266000,China)
出处
《中华骨质疏松和骨矿盐疾病杂志》
CSCD
北大核心
2020年第4期289-295,共7页
Chinese Journal Of Osteoporosis And Bone Mineral Research
基金
国家自然科学基金青年项目(81800769)。
关键词
妊娠哺乳相关骨质疏松症
双膦酸盐
骨密度
pregnancy and lactation-associated osteoporosis
bisphosphonate
bone mineral density
