摘要
目的探讨骨化三醇和唑来膦酸联合运用对老年糖尿病合并骨质疏松症患者的血糖代谢及血清骨代谢标志物骨特异性碱性磷酸酶(BALP)和Ⅰ型胶原交联C⁃末端肽(CTX)的影响。方法选取2021年1月至2023年6月山东省聊城市第二人民医院内分泌科80例老年2型糖尿病骨质疏松患者为研究对象,其中男性38名,女性42名。采用随机对照试验设计,分为观察组和对照组,每组各40例。观察组应用骨化三醇联合唑来膦酸治疗,对照组应用唑来膦酸治疗,2组患者均口服维D钙咀嚼片(商品名:迪巧,美国安士制药有限公司)0.75 g,每天2次,连续治疗6个月。统计比较2组患者疗效、骨密度、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、血清BALP和血清CTX水平。结果治疗6个月后观察组FBG为(8.04±0.66)mmol/L、2 hPG为(12.18±0.91)mmol、HbA1c为(8.39±0.69)%,与对照组[(8.17±0.67)mmol/L、(12.44±0.79)mmol/L)、(8.54±0.62)%]相比较,差异无统计学意义(P>0.05)。治疗6个月后观察组左股骨粗隆、右前臂、右股骨颈、腰椎正位骨密度为(0.86±0.14)、(0.76±0.11)、(0.78±0.13)、(0.77±0.12)g/cm^(3),高于对照组[(0.74±0.12)、(0.69±0.13)、(0.71±0.14)、(0.71±0.08)g/cm^(3)],差异有统计学意义(P<0.05)。治疗6个月后观察组血清中CTX为(0.047±0.09)ng/ml、BALP为(11.58±2.21)U/L,低于对照组[(0.556±0.15)ng/ml、(14.94±2.25)U/L],差异有统计学意义(P<0.05)。观察组总有效率为97.50%,高于对照组(82.50%),差异有统计学意义(P<0.05);2组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论骨化三醇联合唑来膦酸治疗老年糖尿病骨质疏松症患者,能够提高其骨密度,调节骨代谢,改善骨质疏松症状,同时对血糖无不良影响。
Objective To investigate the effects of calcitriol combined with zoledronic acid on glycometabolism and serum bone⁃specific alkaline phosphatase(BALP)and C⁃terminal telopeptide of typeⅠcollagen(CTX)in elderly patients with diabetes mellitus and osteoporosis.Methods A total of 80 patients with type 2 diabetes mellitus and osteoporosis admitted to Department of Endocrine,The Second People’s Hospital of Liaocheng from January 2021 to June 2023 were selected as research subjects.There were 38 males and 42 females.They were randomly divided into observation group and control group,with 40 cases in each group.The observation group was treated with calcitriol combined with zoledronic acid,and the control group was treated with zoledronic acid alone.Moreover,the patients in both groups were orally given 0.75 g of vitamin D calcium chewable tablets twice a day for 6 consecutive months.The efficacy,bone mineral density,fasting blood glucose(FPG),2 h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),serum BALP and CTX were compared between the two groups.Results After 6 months of treatment,there were no significant differences in the FBG,2hPG or HbA1c between the observation group and control group([8.04±0.66]mmol/L vs.[8.17±0.67]mmol/L,[12.18±0.91]mmol/L vs.[12.44±0.79]mmol/L,8.39%±0.69%vs.8.54%±0.62%,P>0.05).After 6 months of treatment,the bone mineral densities at left femoral trochanter,right forearm,right femoral neck,and lumbar spine in the observation group were significantly higher than those in the control group([0.86±0.14]g/cm^(3)vs.[0.74±0.12]g/cm^(3),[0.76±0.11]g/cm^(3)vs.[0.69±0.13]g/cm^(3),[0.78±0.13]g/cm^(3)vs.[0.71±0.14]g/cm^(3),[0.77±0.12]g/cm^(3)vs.[0.71±0.08]g/cm^(3),P<0.05).After 6 months of treatment,the levels of CTX and B⁃ALP in the observation group were significantly lower than those in the control group([0.047±0.09]ng/ml vs.[0.556±0.15]ng/ml,[11.58±2.21]U/L vs.[14.94±2.25]U/L,P<0.05).The overall effective rate in the observation group was 97.50%,which was h
作者
于姗
陈媛媛
赵夏
黑静友
Yu Shan;Chen Yuanyuan;Zhao Xia;Hei Jingyou(Department of Endocrine,The Second People’s Hospital of Liaocheng,Linqing 252600,China)
出处
《海军医学杂志》
2024年第7期700-704,共5页
Journal of Navy Medicine
基金
山东省自然科学基金(ZR2022QH110)。
关键词
骨化三醇
唑来膦酸
糖尿病
骨质疏松症
Calcitriol
Zoledronic acid
Diabetes mellitus
Osteoporosis
