绝经后骨松患者替勃龙治疗半年骨代谢指标的变化

摘要

目的：观察绝经后骨质疏松（ PMOP）患者替勃龙治疗半年骨特异性碱性磷酸酶（ BALP）和抗酒石酸酸性磷酸酶（ TRAP）的变化。方法绝经后女性按双能X线骨密度检查结果分为PMOP组（骨松组， N＝30例）及非骨松组（ N＝30例），30例育龄期骨密度正常女性为对照组，测定其血清BALP、TRAP水平。骨松组服用替勃龙（2．5 mg／d）6个月，测定治疗前及治疗后3、6月骨密度（ BMD），治疗前及治疗后1、3、6月血清TRAP、BALP水平变化。结果与对照组比较，绝经后骨松组及非骨松组的血清TRAP、BALP水平均明显升高，差异有显著性（ P＜0．01）；骨松组血清TRAP、BALP水平较非骨松组进一步升高，差异有显著性（ P ＜0．01）。骨松组应用替勃龙治疗3月后 BMD较治疗前增加，但差异无显著性（ P＞0．05），治疗6月后BMD与治疗前相比显著增加（ P＜0．05）；其血清TRAP、BALP水平在治疗1月后，与治疗前相比较均开始降低，差异有显著性（P＜0．05），治疗3月后，骨代谢指标均下降，差异有显著性（P＜0．01），治疗6月后，其水平进一步下降（ P＜0．01）。结论骨代谢生化指标TRAP和BALP的检测，可以早期评价骨转换情况，联合BMD测定可以及时监测替勃龙的药物疗效。%Objective To observe the changes of bone specific alkaline phosphatase ( BALP ) and tartrate-resistant acid phosphatase ( TRAP) in patients with postmenopausal osteoporosis ( PMOP) after 6-month tibolone treatment.Methods All of 60 postmenopausal women were divided to osteoporosis group (n=30) and non-osteoporosis group (n=30), according to dual-energy X-ray absorptiometry measurement results.Control group contained 30 childbearing-age women with normal bone mineral density (BMD).Serum BALP and TRAP were detected.Women in PMOP group received tibolone (2.5 mg/d) treatment for 6 months.BMD were measured at 0, 3, and 6 months, and BALP and TRAP were detected at 0, 1, 3, and 6 months.Results Serum BALP and TRAP in PMOP group and non-PMOP group had significantly higher levels compared to those in control group ( P<0.01).BALP and TRAP in PMOP group increased further more than those in non-PMOP group (P<0.01).BMD in PMOP group increased after 3-month tibolone treatment but without significant difference ( P >0.05 ) .Significant improvement was observed at 6 month (P<0.05).BALP and TRAP in PMOP group significantly decreased at 1 month compared to baseline (P<0.05), and further decline appeared at 3 and 6 months (P<0.01).Conclusion Bone metabolic biochemical markers, such as BALP and TRAP, can provide an early evaluation of bone turnover.It can timely monitor the drug efficacy of tibolone when combines with BMD measurement.