目的：观察唑来膦酸（密固达，5 mg/100 ml）治疗糖皮质激素性骨质疏松症（ GIO）患者的一年临床疗效、安全性及患者依从性。方法以8例糖皮质激素性骨质疏松症患者为观察对象，应用唑来膦酸，每年静滴一次5 mg/100 ml，同时口服钙尔奇D和阿法骨化醇胶丸0.25 ug，治疗前后采用双能X线骨密度仪，测定骨密度，观察骨密度变化情况及用药过程中及近一年出现的不良反应。结果8例患者治疗一年后腰椎、股骨颈及大转子部位骨密度较治疗前增加（P＜0.05），无新骨折发生，有两例病人用药后三天出现发热及流感样症状，其他病人观察过程中，无不良反应发生。8例患者有1例患者已连续用药三次，3例患者已接受第二次给药，4例患者复查骨密度恢复正常后，暂缓用药。结论唑来膦酸治疗糖皮质激素性骨质疏松症可以增加骨密度、提高生活质量、减少骨折的发生，是一种安全有效、患者依从性较高的药物。%Objective To investigate the 1-year therapeutic effect and safety of zoledronic acid ( Aclasta, 5mg/100ml) on glucocorticoid-induced osteoporosis ( GIO) and the compliance of the patients.Methods Eight patients with GIO were selected . All the patients received an intravenous infusion of 5mg/100ml zoledronic acid once a year .Patients were given an oral medication of Caltrate D and 0.25ug alfacalcidol simultaneously .Bone mineral density was detected using dual energy X-ray absorptiometry before and after the treatment .The changes of bone mineral density and the adverse reaction during the treatment and within 1 year after the treatment were observed .Results After 1-year treatment, the bone mineral density of the lumbar vertebrae, the femoral neck, and the greater trochanter in all 8 patients increased compared with that before the treatment ( P <0.05 ) .No new fractures were observed.Two patients appeared fever and influenza symptom at the 3 rd day after the treatment.All the other patients had no adverse reaction.One of the 8 patients received zoledronic acid for 3 times continuously, and 3 had received zoledronic acid for 2 times. Four patients stopped zoledronic acid after the recovery of bone mineral density to normal level.Conclusion In the treatment of GIO, zoledronic acid can increase bone mineral density , improve the quality of life , and reduce the occurrence of fractures .So, zoledronic acid is an effective , safe, and good compliable drug .
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