CAJ | 학술논문

目的：观察唑来膦酸（5mg/100ml）在原发性骨质疏松症及糖尿病合并骨质疏松症患者中的疗效及安全性。方法收集我院住院的骨质疏松症患者46例，分为原发性骨质疏松症组25例及糖尿病合并骨质疏松症组21例，体格检查计算体质指数（BMI），葡萄糖氧化酶法检测血糖，双能X线骨密度仪测定腰椎（L2-L4）及左股骨颈BMD，所有患者均静脉给予唑来膦酸5 mg治疗，观察不良反应。1年后再次复查骨密度，观察唑来膦酸治疗后骨密度变化。结果治疗前两组间年龄、体质指数、腰椎及股骨颈骨密度无明显差异（P＞0.05），给予唑来膦酸治疗后，两组均出现不同程度的发热、乏力、头痛、关节痛、恶心等反应，糖尿病组有7例出现血糖一过性升高，但3天后均症状消失、血糖回复正常。使用唑来膦酸1年后复查骨密度，原发性骨质疏松组腰椎骨密度升高4.27％，股骨颈升高4.11％，糖尿病合并骨质疏松组骨密度分别升高3.42％、3.26％。两组骨密度较用药前均有升高（P＜0.05），但两组间骨密度比较无差异（P＞0.05）。结论唑来膦酸可以提高骨质疏松症患者骨密度，在原发性骨质疏松症及糖尿病合并骨质疏松症患者中均有较好疗效。
목적：관찰서래련산（5mg/100ml）재원발성골질소송증급당뇨병합병골질소송증환자중적료효급안전성。방법수집아원주원적골질소송증환자46례，분위원발성골질소송증조25례급당뇨병합병골질소송증조21례，체격검사계산체질지수（BMI），포도당양화매법검측혈당，쌍능X선골밀도의측정요추（L2-L4）급좌고골경BMD，소유환자균정맥급여서래련산5 mg치료，관찰불량반응。1년후재차복사골밀도，관찰서래련산치료후골밀도변화。결과치료전량조간년령、체질지수、요추급고골경골밀도무명현차이（P＞0.05），급여서래련산치료후，량조균출현불동정도적발열、핍력、두통、관절통、악심등반응，당뇨병조유7례출현혈당일과성승고，단3천후균증상소실、혈당회복정상。사용서래련산1년후복사골밀도，원발성골질소송조요추골밀도승고4.27％，고골경승고4.11％，당뇨병합병골질소송조골밀도분별승고3.42％、3.26％。량조골밀도교용약전균유승고（P＜0.05），단량조간골밀도비교무차이（P＞0.05）。결론서래련산가이제고골질소송증환자골밀도，재원발성골질소송증급당뇨병합병골질소송증환자중균유교호료효。
Objective To observe the safety and efficacy of intravenous infusion of zoledronic acid ( 5 mg/100 ml ) in the treatment of primary osteoporosis and type 2 diabetes combined with osteoporosis.Methods Forty-six patients with osteoporosis, who were treated in our hospital, were selected.Among all the patients, 25 patients were divided into primary osteoporosis group, and 21 patients were divided into type 2 diabetes combined with osteoporosis group.Physical examination was performed, and the body mass index ( BMI ) was calculated.Serum glucose was detected using glucose oxidase method.The bone mineral density ( BMD) of the lumbar vertebrae ( L2-L4 ) and the left femoral neck was detected using dual energy X-ray absorptiometry ( DXA) . All the patients were treated with intravenous infusion of zoledronic acid.The adverse effect was monitored.One year later, BMD was re-detected, and the change of BMD after the treatment was also observed.Results No significant difference of age, BMI, and BMD of the lumbar vertebrae and the left femoral neck between the two groups was observed (P>0.05).After the intravenous infusion of zoledronic acid, the adverse effect including fever, acratia, headache, arthralgia, and nausea was observed in both groups.Seven patients in type 2 diabetes combined with osteoporosis group showed a transient increase of blood glucose, but all the symptoms disappeared and blood glucose returned to normal in 3 days.After 1-year treatment with zoledronic acid, BMD of the lumbar vertebrae and the left femoral neck in primary osteoporosis group increased by 4.27% and 4.11%, respectively, which increased by 3.42% and 3.26% in type 2 diabetes combined with osteoporosis group, respectively.BMD in both groups was significant higher than that before the treatment (P<0.05), but no significant difference between two groups was observed (P>0.05).Conclusion Zoledronic acid can increase BMD in patients with osteoporosis.And it has a good efficacy for the patients with primary osteoporosis or type 2 diabetes combined with osteoporosis.