CAJ | 학술논문

目的探讨绝经后骨质疏松妇女跌倒风险的干预效果.方法 200例绝经后骨质疏松或骨量减少妇女,平衡测试提示跌倒中高风险,随机分成A、B两组进行跌倒风险干预.A组干预内容包括,骨化三醇0.25 μg,1次/d;跌倒风险和骨质疏松教育;平衡训练;下肢肌力锻炼.B组,骨化三醇0.25 μg/d.所有患者每天均补充元素钙600 mg和维生素D125 IU.评价指标包括跌倒指数、骨密度、血钙磷及不良反应观察.结果干预3个月后,两组患者跌倒指数较干预前自身比较均明显下降(A组t=2.16,P=0.03;B组t=2.08,P=0.04),组间比较差异未见统计学意义;干预6个月后,两组患者跌倒指数继续下降,A组患者跌倒指数下降明显,与B组比较差异有统计学意义(t=2.07,P=0.04);干预1年后,A组跌倒指数较B组进一步降低(t=2.66,P=0.01).结论活性维生素D干预3个月即可有效地降低绝经后骨质疏松及其高危人群的跌倒风险,干预12个月可同时提高腰椎骨密度;联合定期的患者教育、平衡训练和肌力锻炼等健康管理措施,跌倒风险干预的有效性和依从性将进一步提高.
목적 탐토절경후골질소송부녀질도풍험적간예효과.방법 200례절경후골질소송혹골량감소부녀,평형측시제시질도중고풍험,수궤분성A、B량조진행질도풍험간예.A조간예내용포괄,골화삼순0.25 μg,1차/d;질도풍험화골질소송교육;평형훈련;하지기력단련.B조,골화삼순0.25 μg/d.소유환자매천균보충원소개600 mg화유생소D125 IU.평개지표포괄질도지수、골밀도、혈개린급불량반응관찰.결과 간예3개월후,량조환자질도지수교간예전자신비교균명현하강(A조t=2.16,P=0.03;B조t=2.08,P=0.04),조간비교차이미견통계학의의;간예6개월후,량조환자질도지수계속하강,A조환자질도지수하강명현,여B조비교차이유통계학의의(t=2.07,P=0.04);간예1년후,A조질도지수교B조진일보강저(t=2.66,P=0.01).결론 활성유생소D간예3개월즉가유효지강저절경후골질소송급기고위인군적질도풍험,간예12개월가동시제고요추골밀도;연합정기적환자교육、평형훈련화기력단련등건강관리조시,질도풍험간예적유효성화의종성장진일보제고.
Objective To investigate the effects of caleitriol,training on balance and lower extremity muscle strength on fall risk of postmenopausal women with osleoporosis or osteopenia.Methods A total of 200 postmenopausal women with osteoporosis or osteopenia,whose balance test confirmed higher fall risk,were randondy assigned to group A or B.Those of group A received the following intervention:( 1 ) 0.25 μg calcitriol,QD; (2) general information on fall and osteoporosis; (3) balance training; (4) lower extremity muscle strength exercises.Those of group B were only treated with 0.25 μg calcitriol.All the participants were supplemented with 600 mg/d calcium and 125 IU/d vitamin D.Fall index,bone mineral density,serum levels of calcium and phosphorus,and adverse reactions were record.Results After 3 months' intervention,the fall index of both groups was significantly decreased ( group A:t =2.16,P＜0.05 ; group B:t =2.08,P＜0.05 ).After 6 months' intervention,the fall index of both groups went on decreasing,and significant difference of fall index between 6 month and baseline of group A and between group A and group B at 6 months was found.After 1-year intervention,the fall index of group A was further decreased in comparison with group B ( t =2.66,P＜0.05 ).No hypercalcemia occurred during the study period.Conclusion The fall risk of the patients with postmenopausal osteoporosis or osteopenia was reduced after 3 months' intervention.Twelve months' active vitamin D intervention could either reduce the risk of fall or improve bone mineral density.Patient education,balance training and muscle exercise may be effective intervention to reduce fall risk.