阿仑膦酸钠联合阿法骨化醇治疗绝经后骨质疏松症患者骨代谢的影响研究

摘要

Objective To investigate the effect of alendronate combined with calcitriol on bone metabolism in the treatment of postmenopausal osteoporosis patients.Methods66 postmenopausal osteoporosis patients from Cancer Hospital of Hangzhou were selected and randomly divided into the control group and the study group.33 cases in the control group were treated by compound calcium amino acid chelate.33 cases in the study group were treated by compound calcium amino acid chelate, alendronate and alfacalcidol.All patients were taking the drug for 48 weeks.The bone mineral density (BMD) of lumbar vertebrae between 4 and 1, Bone alkaline phosphatase (BALP) and bone metabolism index of left femur (BMD) Type I collagen C end peptide (CTX), acid phosphatase (TRAP), parathyroid hormone (PTH) and clinical curative effect were compared.ResultsAfter treatment, the clinical effective rate of the study group (93.94%) was higher than that of the control group (72.73%), the difference was statistically significant (P<0.05).Compared with the control group,the level of bone mineral density of lumbar spine was increased from 1 to 4, and the level of TRAP, CTX, PTH and BALP were increased,the difference was statistically significant (P<0.05).There was no difference in adverse effects between the two groups.ConclusionThe combination of the application of sodium hyaluronate and the combination of the method can effectively improve the bone mineral density and bone metabolism in postmenopausal women with osteoporosis, and improve the clinical efficacy.%目的 探讨阿仑膦酸钠联合阿法骨化醇治疗妇女绝经后骨质疏松症的患者骨代谢的影响.方法 选取杭州市肿瘤医院妇科门诊确诊并治疗的绝经后骨质疏松症患者66例,按随机数字表法进行分组,对照组33例患者给予复方氨基酸鳌合钙;研究组33例患者予以复方氨基酸鳌合钙、阿仑膦酸钠及阿法骨化醇胶囊,所有患者连续服药48w.观察并记录2组间腰椎1~4节骨密度(BMD)、左股骨密度(BMD)及骨代谢指标骨碱性磷酸酶(BALP)、Ⅰ型胶原C端肽(CTX)、抗酒石酸酸性磷酸酶(TRAP)、甲状旁腺素(PTH),同时对比临床疗效.结果 研究组治疗后临床有效率93.94%高于对照组治疗后临床有效率72.73%,差异具有统计学意义(P<0.05);与对照组比较,研究组治疗后腰椎1~4节、左股骨骨密度水平升高,BALP、CTX、TRAP、PTH水平显著降低,具有统计学意义(P<0.05).2组无恶性不良反应,不良率差异无统计学意义.结论 阿仑膦酸钠与阿法骨化醇联合应用能有效改善妇女绝经后骨质疏松症患者骨密度及骨代谢水平,提高临床疗效.