目的 观察帕米膦酸二钠治疗绝经后妇女骨质疏松症( PMOP)3年疗效.方法选取2007年8月至2008年6月PMOP患者97例,每月3次静脉输注帕米膦酸钠30 mg,同时每天补充钙剂800～1 200 mg和活性维生素D 0.25 μg,疗程3年.定期测定治疗前后腰椎、股骨颈与全髋骨密度值(BMD)及骨转换标记物(血清CTX、尿CTX、NTX、血清TRACPSb).结果①治疗3年后,腰椎、股骨颈和全髋部位BMD均较治疗前相比,差异有统计学意义(P＜0.001)；②治疗6个月,血清Ⅰ型胶原交联羧基端肽(CTX)、Ⅰ型胶原交联氨基端肽(NTX)、尿CTX/Cr、尿NTX/Cr、尿吡啶啉/肌酐(PYD/Cr)、尿脱氧吡啶啉/肌酐(DPYD/Cr)和血浆抗酒石酸酸性磷酸酶均较治疗前显著下降(P＜0.01),其后各骨转换标记物仍维持较低水平,但无进一步下降.Pearson相关分析显示治疗6个月时尿吡啶啉和脱氧吡啶啉、血浆抗酒石酸酸性磷酸酶的变化与3年后腰椎、股骨颈和全髋部位BMD的变化值均呈负相关(P＜0.01).③治疗后疼痛明显缓解生活能力明显改善,治疗期间新发骨折2例.结论帕米膦酸二钠治疗PMOP安全有效,早期骨转换标记物的下降与3年后骨密度的改善呈负相关.%Objective To objective the curative effect of Pamidronate disodium with the treatment of the postmenopausal osteoporosis women. Methods Selected 97 PMOP patients which were in clinic from Aug, 2007 to Jun, 2008. All the patients had been injected with Pamidronate disodium three times a month and taken calcium 800mg - 1200mg and activated vitamin D 0.25ug everyday. The treatment lasted 3 years. Then tested the BMD of lumbar, femoral neck and total hip and tested the CTX of serum and urine, NTX and TRACP5b of serum. Results ①The treatment in the three years. (P <0.001) The BMD of lumbar, femoral neck and total hip has been improved significantly after. ②The CTX,NTX, CTX/Cr of urine, NTX/Cr of urine, PYD/Cr, DPYD/Cr and TRAP had been descended after the treatment. (P < 0.01). Then all the indexes are in a low level, no more descened. Pearson Correlation analysis shows that the changes of PYD, DPYD and PRAP at the 6th month of the treatment are in a negative correlation to the changes of BMD of lumbar, femoral neck and total hip after three years with the treatment. (P <0.01) ,(H)A11 the patients had been reduced the pains and improved the ability of living. There were 2 fracture patients during the treatment . Conclusion It is safe and effective with the treatment of Pamidronate disodium to the PMOP. There is a negative correlation between the decline of BTM in the early time to the improvement of BMD after 3years.
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