CAJ | 학술논문

目的：观察鲑鱼降钙素联合阿仑膦酸钠对老年骨质疏松的疗效以及探讨其影响骨代谢的调控机制。方法将本院收治的60例伴有疼痛症状的老年骨质疏松患者，计算机随机分为2组，对照组27例，治疗组33例，对照组口服阿仑膦酸钠70 mg／次／周，治疗组在对照组治疗基础上注射鲑鱼降钙素，50 IU／次，每天，连续7d，第8 d开始以同等剂量隔天注射，第14 d开始同等剂量2次／周，28 d为一个疗程，共6个疗程，检测治疗前后患者疼痛症状、骨密度、血清1，25－（OH）2D3和PTH水平的变化情况。结果①两组治疗后腰背痛量化结果均有一定程度的改善；与对照组比较，治疗组VAS等级综合评分显著下降，差异有统计学意义（ P＜0．05），对照组腰背痛VAS等级综合评分均＞5，而治疗组评分均＜4；②两组治疗后第1－4腰椎（ L1－L4）和股骨颈、总髋部的骨密度与治疗前相比均具统计学差异（P＜0．05），其中治疗组治疗后骨密度远高于对照组（P＜0．05）；对照组与治疗组在治疗后的T值均显著高于治疗前（P＜0．05），且治疗组显著高于对照组（P＜0．05）；③治疗后对照组患者血清1，25－（OH）2D3水平明显低于治疗组（P＜0．05），对照组血清PTH含量明显高于治疗组（P＜0．05）。结论骨质疏松发生发展过程中伴有腰背疼痛，骨密度降低，鲑鱼降钙素联合阿仑膦酸钠可能通过增加1，25－（OH）2D3，抑制PTH的合成来改善骨质疏松症状。
목적：관찰해어강개소연합아륜련산납대노년골질소송적료효이급탐토기영향골대사적조공궤제。방법장본원수치적60례반유동통증상적노년골질소송환자，계산궤수궤분위2조，대조조27례，치료조33례，대조조구복아륜련산납70 mg／차／주，치료조재대조조치료기출상주사해어강개소，50 IU／차，매천，련속7d，제8 d개시이동등제량격천주사，제14 d개시동등제량2차／주，28 d위일개료정，공6개료정，검측치료전후환자동통증상、골밀도、혈청1，25－（OH）2D3화PTH수평적변화정황。결과①량조치료후요배통양화결과균유일정정도적개선；여대조조비교，치료조VAS등급종합평분현저하강，차이유통계학의의（ P＜0．05），대조조요배통VAS등급종합평분균＞5，이치료조평분균＜4；②량조치료후제1－4요추（ L1－L4）화고골경、총관부적골밀도여치료전상비균구통계학차이（P＜0．05），기중치료조치료후골밀도원고우대조조（P＜0．05）；대조조여치료조재치료후적T치균현저고우치료전（P＜0．05），차치료조현저고우대조조（P＜0．05）；③치료후대조조환자혈청1，25－（OH）2D3수평명현저우치료조（P＜0．05），대조조혈청PTH함량명현고우치료조（P＜0．05）。결론골질소송발생발전과정중반유요배동통，골밀도강저，해어강개소연합아륜련산납가능통과증가1，25－（OH）2D3，억제PTH적합성래개선골질소송증상。
Objective To observe the efficacy of salmon calcitonin combined with alendronate sodium on the treatment of senile osteoporosis and to explore its mechanism of regulation of bone metabolism.Methods Sixty elderly patients with osteoporosis were divided into two groups, 27 cases in the control group and 33 cases in the treatment group.The patients in control group received 70mg alendronate per day.The patients in the treatment group received intramuscular injection of 50 IU/day salmon for 7 days, and every other day from the eighth day, and twice weekly from the fourteenth day, besides the alendronate treatment.One treatment course was 28 days, and the treatment lasted for 6 courses.The pain symptom before and after treatment, bone mineral density (BMD), serum 1,25-(OH)2D3, and PTH were detected.Results 1) The back pain in patients of both groups relieved after the treatment.Comparing to that in control group (VAS>5), VAS in the treatment group (VAS<4) decreased significantly (P<0.05).2) After the treatment, BMD of the lumbar spine (L1-L4), femoral neck, and total hip was different comparing to that before the treatment in both groups (P<0.05).BMD was much higher in the treatment group than that in control group (P<0.05).T value after the treatment was significantly higher than that before the treatment in both groups, and it was higher in the treatment group than in control group.3) After the treatment, serum 1,25-(OH)2D3 was significantly lower in control group than in the treatment group, but PTH content was significantly higher in control group ( P<0.05 ) .Conclusion The back pain and decrease of BMD occur during the development process of osteoporosis.Salmon calcitonin combined with alendronate sodium relieves the symptom of osteoporosis by increasing 1,25-(OH)2D3 and inhibiting PTH synthesis.