CAJ | 학술논문

目的：观察替勃龙对绝经后股骨颈骨折妇女骨代谢的影响。方法采用自愿的原则，选取自然绝经＞1年，年龄＜60岁，无雌孕激素使用禁忌证，股骨颈骨折妇女58例作为研究对象，其中30例给予替勃龙＋维 D 钙咀嚼片者为观察组；28例仅给予维 D 钙咀嚼片者为对照组。2组均于手术治疗前及治疗后6个月，采用双能骨密度仪测定骨密度，测定血清钙、磷、碱性磷酸酶（ALP）变化，用药物前后检查肝肾功能及子宫内膜厚度，定期复查骨折处X 线平片。结果观察组退出试验8例（失访5例，未坚持服药3例），完成疗程22例。观察组治疗后较治疗前腰椎、股骨颈、大转子、粗隆间等部位骨密度增加明显，有显著性差异（ P ＜0．05）。对照组治疗后较治疗前腰椎、股骨颈处骨密度明显增加（ P ＜0．05），大转子、粗隆间增加不明显（ P ＞0．05）。治疗后观察组腰椎、股骨颈处骨密度明显高于对照组，差异有统计学意义（ P ＜0．05）。观察组愈合时间短于对照组，差异有统计学意义（ P ＜0．05）。2组患者治疗前后血钙、磷、碱性磷酸酶变化无显著性差异（ P ＞0．05）；肝肾功能及子宫内膜厚度亦无明显改变（ P ＞0．05）。结论替勃龙辅助治疗绝经后女性骨折患者，可以有效改善骨密度，调节骨代谢，是一种有效可行的方法。
목적：관찰체발룡대절경후고골경골절부녀골대사적영향。방법채용자원적원칙，선취자연절경＞1년，년령＜60세，무자잉격소사용금기증，고골경골절부녀58례작위연구대상，기중30례급여체발룡＋유 D 개저작편자위관찰조；28례부급여유 D 개저작편자위대조조。2조균우수술치료전급치료후6개월，채용쌍능골밀도의측정골밀도，측정혈청개、린、감성린산매（ALP）변화，용약물전후검사간신공능급자궁내막후도，정기복사골절처X 선평편。결과관찰조퇴출시험8례（실방5례，미견지복약3례），완성료정22례。관찰조치료후교치료전요추、고골경、대전자、조륭간등부위골밀도증가명현，유현저성차이（ P ＜0．05）。대조조치료후교치료전요추、고골경처골밀도명현증가（ P ＜0．05），대전자、조륭간증가불명현（ P ＞0．05）。치료후관찰조요추、고골경처골밀도명현고우대조조，차이유통계학의의（ P ＜0．05）。관찰조유합시간단우대조조，차이유통계학의의（ P ＜0．05）。2조환자치료전후혈개、린、감성린산매변화무현저성차이（ P ＞0．05）；간신공능급자궁내막후도역무명현개변（ P ＞0．05）。결론체발룡보조치료절경후녀성골절환자，가이유효개선골밀도，조절골대사，시일충유효가행적방법。
Objective To observe the influence of tibolone on bone metabolism in postmenopausal women with femo -ral neck fracture.Methods According to volunteer principle ,totally 58 women with femoral nect fracture were enrolled , men-opaused over 1 year, age <60 and without estrogen and progesterone contraindication .All women were divided into 2 groups:30 cases in observation group were treated with tibolone and Vit -D +Calcium chewable tablets,28 cases in conrol group were treated with Vit-D +Calcium chewable tablets .Before operation and 6 months afeter treatment, the quantitative changes in bone mineral density were measured ,the serum calcium,phosphorus,alkaline phosphatase (ALP),liver and renal function , thickness of uterine endometrium were examined , X-ray plain film of fracture were examined periodically .Results 8 cases in observation group quit the trial (5 cases loss follow-up,3 cases failure to take the durg ),22 cases completed the treatment course,compared with those before treatment ,the lumbar vertebrae ,femoral neck, greater trochanter and interchanteric bone density increased significantly in observation group ( P <0.05),in control group, the lumbar vertebrae ,femoral neck bone dentisy increased significantly after treatment ( P <0.05),while greater trochanter and interchanteric bone density had no difference( P >0.05),there were significant difference between the two groups in the lumbar vertebrae ,femoral neck bone dentisy( P <0.05).The healing time in observation group was thorter than control group ( P <0.05).there were no signifi-cant changes in serum calcium,phosphorus,ALP,liver and renal function ,thickness of uterine endometrium ( P >0.05). Conclusion Tibolone could assist in the treatment of postmenopausal women with fracture ,improve the bone density effective -ly,regulate the bone mebatlism,which is an effective and feasible method .