阿伦膦酸钠维D3与钙剂对老年脑梗死患者骨生化与转换指标的影响

摘要

目的：研究老年脑梗死患者应用阿伦膦酸钠维D3与钙剂等骨质疏松干预治疗前后骨密度、骨生化与转换相关指标变化。方法应用骨密度仪对受试者足踝部进行骨密度（BMD）测定。应用偶氮胂Ⅲ法检测血钙与钼酸盐法检测血磷，应用双抗体夹心法检测人25羟基维生素 D3[25（OH）D3]、甲状旁腺素（PTH）、骨钙素（BGP）、1型胶原羧基末端肽（β-CTX）、1型前胶原氨基端肽（P1 NP）、骨源性碱性磷酸酶（BALP）。结果干预组患者干预前后除血Ca2＋、血P3＋分别互相比较无统计学差异（t＝1．430，1．528，P＞0．05）外，25（OH）D3、PTH、BGP、P1NP、BALP与β-CTX分别互相比较均有统计学差异（t＝-25．964，-3．441，-3．079，-2．074，4．182，5．149，P＜0．05）。结论对老年脑梗死急性期后伴肢体瘫痪患者在常规应用脑梗死药物治疗基础上，进行肢体康复治疗同时给予阿伦膦酸钠维 D3与钙剂等骨质疏松干预治疗，对促进骨形成和抑制骨吸收有一定作用。%Objective To research the bone mineral density and bone biochemical and turnover markers before and after the intervention treatment of osteoporosis including alendronate sodium Vitamin D3 and calcium in elderly patients with cerebral infarction.Methods The bone mineral density (BMD)measurement was measured by bone densitometer in the ankles of volunteers.The blood calcium was detected with arsenazo III colorimetry and the blood phosphorus was detected with molybdate method.Meanwhile,the 25-hydroxy-Vitamin D[25(OH)D3],parathyrin(PTH),bone glia pro-tein (BGP),type Ⅰ collagen carboxy-terminal peptide(β-CTX),procollagen I N-terminal peptide(P1 NP)and Bone al-kaline phosphatase(BALP)was detected using enzyme-linked immuno sorbent assay.Results The blood calcium and phosphorus of intervention patients before and after treatment had no statistical difference(t=1.430,1.528,P>0.05), however,the 25 (OH)D3、PTH 、BGP、P1NP、BALP and β-CTX showed statistically significant difference (t=-25.964,-3.441,-3.079,-2.074,4.182,5.149,P<0.05).Conclusion On the base of ordinary drug therapy,the elderly patients late in acute cerebral infarction with limb paralysis could be treated with limb rehabilitation as well as intervention treatment of osteoporosis including alendronate sodium Vitamin D3 and calcium,which improves bone for-mation and inhibits osteoclast resorption.