摘要
目的探究特立帕肽联合阿仑膦酸钠对骨质疏松症患者骨钙素、Ⅰ型胶原交联C端肽(CTX)、Ⅰ型胶原交联N端肽(NTX)水平的影响。方法选取2019年3月至2020年10月在苏州市中西医结合医院治疗的48例骨质疏松患者,根据随机数字表法分为对照组(采用阿仑膦酸钠治疗)和试验组(采用特立帕肽联合阿仑膦酸钠治疗),每组24例。两组均连续治疗1年。使用双能X线骨密度仪检测患者腰椎、股骨颈的骨密度;采用免疫透射比浊法检测吡啶酚(PYD)、骨钙素、CTX水平;采用酶联免疫吸附法检测Ⅰ型前胶原N端肽(PINP)、NTX、抗酒石酸酸性磷酸酶5b(TRAP-5b)、骨特异性碱性磷酸酶(BALP)水平;采用化学发光法检测骨保护素(OPG)水平;采用数字疼痛评分(NRS)、生活质量量表(SF-36)评价患者疼痛情况、生活质量。比较两组治疗前后上述指标的变化,评估两组治疗效果。结果治疗后,试验组腰椎骨密度T值、股骨颈骨密度T值、骨钙素、BALP、OPG、PINP水平以及生活质量量表(SF-36)评分均高于对照组(均P<0.05)。而试验组血清CTX、NTX、TRAP-5b、PYD水平以及NRS评分均低于对照组(均P<0.05)。试验组治疗总有效率高于对照组[62.50%(15/24)比91.66%(22/24)](P<0.05),且试验组疗效优于对照组(P<0.05)。结论特立帕肽联合阿仑膦酸钠可有效提高骨质疏松症患者的骨密度,且可促进骨吸收、骨代谢、骨形成,有助于减轻患者疼痛,提高生活质量。
Objective To investigate the effects of teriparatide combined with alendronate on the levels of osteocalcin,collagen typeⅠcross-linked C-telopeptide(CTX)and collagen typeⅠcross-linked N-telopeptide(NTX)in patients with osteoporosis.Methods A total of 48 patients with osteoporosis treated in Suzhou Integrated Traditional and Western Medicine Hospital from Mar.2019 to Oct.2020 were included and divided into a control group(treated with alendronate)and a test group(treated with teriparatide and alendronate)according to the number table method,with 24 patients in each group.Both groups were treated continuously for one year.Bone mineral density of lumbar vertebrae and femoral neck was measured by dual energy X-ray bone densitometer;pyridinoline(PYD),osteocalcin and CTX were detected by immunoturbidimetry;the levels of procollagen typeⅠN-terminal peptide(PINP),NTX,tartrate resistant acid phosphatase 5b(TRAP-5b)and bone specific alkaline phosphatase(BALP)were detected by enzyme-linked immunosorbent assay;the level of osteoprotegerin(OPG)was detected by chemiluminescence method;NRS and SF-36 were used to evaluate the pain and quality of life of the patients.The changes of the above indicators before and after treatment in the two groups were compared,and the treatment effect of the two groups was evaluated.Results After treatment,the lumbar bone mineral density T value,femoral neck bone mineral density T value,osteocalcin,BALP,OPG,PINP levels and quality of life scale(SF-36)scores in the test group were higher than those in the control group(all P<0.05).The levels of serum CTX,NTX,TRAP-5b,PYD and NRS score in the test group were lower than those in the control group(all P<0.05).The total effective rate of the test group was higher than that of the control group[62.50%(15/24)vs 91.66%(22/24)](P<0.05),and the curative effect of the test group was better than that of the control group(P<0.05).Conclusion Teriparatide combined with alendronate can effectively improve the bone density of patients with osteoporosis,and c
作者
曹峰
仓挺松
李光飞
沈为苟
吴晓东
吴骏
CAO Feng;CANG Tingsong;LI Guangfei;SHEN Weigou;WU Xiaodong;WU Jun(Department of Orthopedics,Suzhou Hospital of Integrated Traditional Chinese and Western Medicine,Suzhou 215101,China;Department of Orthopedics,the Second Affiliated Hospital of SooChow University,Suzhou 215004,China)
出处
《医学综述》
CAS
2023年第1期193-198,共6页
Medical Recapitulate
基金
苏州市中西医结合医院院级课题(YJ2019003)。
关键词
骨质疏松症
特立帕肽
阿仑膦酸钠
骨代谢
骨形成
骨转移
Osteoporosis
Teriparatide
Alendronate
Bone metabolism
Bone formation
Bone metastasis
