阿仑膦酸钠与唑来膦酸治疗绝经后骨质疏松症疗效比较

摘要

Objective To retrospective investigation and analysis the therapeutic effects of one year weekly oral alendronate ( ALN) or once-yearly i. v. infusion of zoledronic acid ( ZOL) treatment in postmenopausal Chinese women with osteoporosis. Methods Eighty women with osteoporosis receiving ALN (70 mg, one time a week, at least 1 year) and 80 women with osteoporosis or osteopenia receiving ZOL ( 5 mg, one time a year, at least 1 year) from Dec 2014 to Jan 2016 were chosen as subjects. Simultaneously, they were treated with calcium 600 mg qd and vitamin D 125 IU qd for 12 months. The bone densitometry at lumbar spine1-4, left femoral neck, total hip bone and bone turnover markerβ-CTX level were measured at baseline and after 1 year of treatment respectively. Results The average age of participants in ALN group and ZOL group were (66. 48±8. 39) years and (65. 11±7. 69) years. After 12 months of treatment, change in BMD in ALN group of L1-4, the femoral neck, the total hip was (5. 46±4. 42)%, (2. 81%±3. 83)%, (2. 72±2. 76)%, respectively (P<0. 001). And change in BMD in ZOL group of L1-4, the femoral neck, the total hip was (6. 66%± 6. 37)%, (1. 97±3. 13)%, (2. 20±3. 63)%, respectively (P<0. 001). There were no significant differences in the im-provement of BMD and bone turnover markers between two groups (P=0. 216, P=0. 132, P=0. 312, P=0. 066). Conclusions Treatment with ALN or ZOL can significantly increased the BMD at lumbar spine, femoral neck and total hip. There are no significant differences in the therapeutic effects between ALN and ZOL treatment.%目的 回顾性分析口服阿仑膦酸钠以及静脉注射唑来膦酸治疗绝经后骨质疏松症的临床疗效.方法 从2014年12月-2016年1月就诊的绝经后骨质疏松妇女中筛选出接受阿仑膦酸钠治疗至少1年和接受唑来膦酸治疗至少1年的妇女各80例作为研究对象,分别为口服阿仑膦酸钠组(70 mg/周)以及静脉注射唑来膦酸组(5 mg/年),所有患者均口服碳酸钙600 mg/d和维生素D 125 IU/d.采集所有患者基线及治疗12个月后腰椎L1-4、 股骨颈和全髋部位的骨密度(bone mineral density,BMD),血清I型胶原羧基端肽交联(carboxy-telopeptide of type I collagen,β-CTX)等资料,进行组间及药物治疗前后对照.结果 阿仑膦酸钠组患者平均年龄(66.48±8.39)岁,唑来膦酸组患者平均年龄(65.11±7.69)岁.治疗12个月后,阿仑膦酸钠组腰椎BMD上升(5.46±4.42)%、 股骨颈BMD上升(2.81±3.83)%,全髋BMD上升(2.72±2.76)%(均P<0.001).唑来膦酸组腰椎BMD上升(6.66±6.37)%、 股骨颈BMD上升(1.97±3.13)%,全髋BMD上升(2.20±3.63)%(均P<0.001).分别比较两药物组腰椎、 股骨颈、 全髋BMD以及β-CTX变化率差异均无统计学意义(P值分别为0.216、0.132、0.312、0.066).结论 阿仑膦酸钠70 mg/周和唑来膦酸5 mg/年治疗1年均能够显著提高绝经后骨质疏松妇女的腰椎以及髋部BMD,两者疗效比较,差异无统计学意义(P>0.05).