CAJ | 학술논문

目的观察阿仑膦酸钠联合阿法骨化醇治疗原发性骨质疏松症的疗效.方法回顾性分析2000年1月至2006年1月本院收治的156例老年原发性骨质疏松症患者的临床资料,分为治疗组和对照组,每组78例.对照组口服碳酸钙D3,治疗组口服碳酸钙D3、阿法骨化醇和阿仑膦酸钠联合治疗,连续12个月.比较两组治疗前后的腰椎侧位(L2～4)和左股骨颈的骨密度(BMD)、血清骨钙素(BGP)和Ⅰ型胶原C端肽(β-CTX)水平.随访3～5年,比较两组患者的骨折发生率.结果与治疗前比较,治疗后对照组腰椎侧位(L2～4)BMD无明显变化(P＞0.05),左股骨颈BMD下降[(0.52±0.07) g/cm2比(0.56±0.09) g/cm2,P＜0.01),血清BGP无明显变化(P＞0.05),血清β-CTX升高[(0.51±0.17) mg/L比(0.40±0.12) mg/L,P＜0.01].与治疗前比较,治疗后治疗组左股骨颈、腰椎侧位(L2～4) BMD增加[(0.72±0.12)g/cm2比(0.55 ±0.08) g/cm2,(0.92±0.17) g/cm2比(0.76±0.13)g/cm2,均P＜0.01],血清BGP增高[(6.31± 1.32) μg/L比(4.19±1.07)μg/L,P＜0.01],血清β-CTX下降[(0.26±0.11) mg/L比(0.55±0.31) mg/L,P＜0.01].随访显示,治疗组和对照组的骨折发生率分别为3.8％(3/78)、21.8％(17/78),治疗组骨折发生率明显下降(P＜0.05).结论阿法骨化醇联合阿仑膦酸钠治疗原发性骨质疏松症临床疗效明显,可降低患者的骨折发生率.
목적 관찰아륜련산납연합아법골화순치료원발성골질소송증적료효.방법 회고성분석2000년1월지2006년1월본원수치적156례노년원발성골질소송증환자적림상자료,분위치료조화대조조,매조78례.대조조구복탄산개D3,치료조구복탄산개D3、아법골화순화아륜련산납연합치료,련속12개월.비교량조치료전후적요추측위(L2～4)화좌고골경적골밀도(BMD)、혈청골개소(BGP)화Ⅰ형효원C단태(β-CTX)수평.수방3～5년,비교량조환자적골절발생솔.결과 여치료전비교,치료후대조조요추측위(L2～4)BMD무명현변화(P＞0.05),좌고골경BMD하강[(0.52±0.07) g/cm2비(0.56±0.09) g/cm2,P＜0.01),혈청BGP무명현변화(P＞0.05),혈청β-CTX승고[(0.51±0.17) mg/L비(0.40±0.12) mg/L,P＜0.01].여치료전비교,치료후치료조좌고골경、요추측위(L2～4) BMD증가[(0.72±0.12)g/cm2비(0.55 ±0.08) g/cm2,(0.92±0.17) g/cm2비(0.76±0.13)g/cm2,균P＜0.01],혈청BGP증고[(6.31± 1.32) μg/L비(4.19±1.07)μg/L,P＜0.01],혈청β-CTX하강[(0.26±0.11) mg/L비(0.55±0.31) mg/L,P＜0.01].수방현시,치료조화대조조적골절발생솔분별위3.8％(3/78)、21.8％(17/78),치료조골절발생솔명현하강(P＜0.05).결론 아법골화순연합아륜련산납치료원발성골질소송증림상료효명현,가강저환자적골절발생솔.
Objective To explore the efficacy of alendronate sodium combined with alfacalcidol in the treatment of primary osteoporosis.Methods Between January 2000 and January 2006,clinical data of 156 elderly patients with primary osteoporosis registered in our hospital were retrospectively analyzed and divided into treatment and control groups (n=78 each).The oral administration of calcium carbonate D3 was taken in the control group for 12 months,while the combined treatment by oral administration of calcium carbonate D3,alendronate sodium and alfacalcidol was taken in the treatment group for 12 months also.The bone mineral density(BMD) of lateral lumbar vertebra (L2-4) and left femoral neck,the levels of serum bone gla protein (BGP) and β-Crosslaps(β-CTX) were compared between two groups before and after treatment.After the following up of 3-5 years,the incidence rates of bone fracture were compared between two groups.Results In the control group,any obvious changes in BMD of lateral lumbar vertebra (L2-4) was not found (P＞0.05),while the BMD of left femoral neck significantly decreased [(0.52±0.07) g/cm2 vs (0.56±0.09) g/cm2,P＜0.01],and no change in serum BCP was found (P＞0.05),while the serum β-CTX increased [(0.51±0.17) mg/L vs (0.40±0.12) mg/L,P＜0.01] after treatment.In treatment group,the BMD of left femoral neck and lateral lumbar vertebra (L2-4) were mcreased [(0.72 ± 0.12) g/cm2 VS (0.55+0.08) g/cm2,(0.92±0.17) g/cm2 VS (0.76±0.13) g/cm2,both P＜0.01],serum BCP increased [(6.31± 1.32) μg/L vs (4.19±1.07) μg/L,P＜0.01] and serum β-CTX decreased [(0.26±0.11) mg/L vs (0.55±0.31) mg/L,P＜O.O1] after treatment.The following-up data showed that the incidence rates of bone fracture were 3.8％(3/78) in treatment group and 21.8％ (17/18) in control group,with a significant decrease in treatment group (P＜0.05).Conclusion The efficacy of alendronate sodium combined with alfacalcidol is good in the treatment of primary osteoporosis,which may reduce the incidence rates of bone fracture.