唑来膦酸对女性骨质疏松症的疗效及其对骨标志物的影响

发布时间：2018-03-09 01:08

本文选题：唑来膦酸　切入点：骨质疏松症　出处：《中国骨质疏松杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨唑来膦酸注射液(密固达)对女性不同原因所致骨质疏松的临床疗效及其对骨代谢标志物的影响。方法回顾性分析2012年4月至2016年7月在长海医院风湿免疫科接受唑来膦酸治疗的119例女性骨质疏松症患者,根据病情分为原发性骨质疏松组和继发性骨质疏松组,其中原发性骨质疏松组66例,年龄52~87岁,平均69.8±9.6岁;继发性骨质疏松组53例,年龄51~82岁,平均66.1±8.4岁;原发性骨质疏松组患者发病年龄高于继发性骨质疏松组患者(P0.05),两组患者在陈旧性骨折史、血钙、血磷、BUN、Cr、骨代谢标志物、骨密度等方面差异均无统计学意义。所有患者均接受每年1次5mg唑来膦酸,联合骨化三醇0.25μg/日和600 mg碳酸钙D3片/日治疗1年。比较两组患者治疗前和治疗1年后腰椎和髋部骨密度及骨代谢相关指标,观察患者药物不良反应和新发骨折情况。结果与治疗前比较,原发性骨质疏松组患者治疗1年后腰椎和髋部骨密度值均明显增加(P0.05或0.01);骨代谢标志物P1NP、β-CTX、N-MID水平均明显下降(P0.01),25羟基维生素D水平明显升高(P0.01)。继发性骨质疏松组患者治疗1年后腰椎(L_2、L_3、L_4、L_(1-4))、髋部大粗隆和髋部平均骨密度值均明显增加(P0.05或0.01),骨代谢标志物P1NP、β-CTX、N-MID水平均明显下降(P0.01)。治疗1年后,继发性骨质疏松组患者N-MID明显低于原发性骨质疏松组(P0.01),两组间腰椎、髋部骨密度值及骨代谢标志物P1NP、β-CTX、25羟基维生素D、PTH水平无明显差异。两组患者治疗前后的血钙、血磷、BUN、Cr水平均无明显变化。治疗期间两组均无新发骨折。原发性骨质疏松组患者出现2例发热,继发性骨质疏松组3例发热,两组患者不良反应发生率无差异。结论唑来膦酸治疗不同原因导致的女性骨质疏松患者能够有效改善骨代谢标志物水平,降低骨吸收,显著提高腰椎、髋部的骨密度,降低骨折风险,不良反应少。
[Abstract]:Objective to investigate the clinical effect of zoledronic acid injection (Mi Gu Da) on female osteoporosis caused by different causes and its effect on bone metabolic markers. Methods Rheumatism in Changhai Hospital from April 2012 to July 2016 was retrospectively analyzed. 119 female patients with osteoporosis treated with zoledronic acid, The patients were divided into primary osteoporosis group (n = 66) and secondary osteoporosis group (n = 66, mean 69.8 卤9.6 years), primary osteoporosis group (n = 66), secondary osteoporosis group (n = 53), mean age of 66.1 卤8.4 years (n = 53). The age of onset in primary osteoporosis group was higher than that in secondary osteoporosis group (P 0.05). There was no significant difference in bone mineral density. All patients received 5 mg zoledronic acid once a year. The bone mineral density (BMD) and bone metabolism of lumbar vertebrae and hip were compared between the two groups before and after treatment for 1 year, combined with 0.25 渭 g / d and 600mg calcium carbonate D3 tablet / day. Adverse drug reactions and new fractures were observed. The results were compared with those before treatment. The bone mineral density of lumbar vertebrae and hip increased significantly after one year of treatment in primary osteoporosis group, and the levels of bone metabolism markers P1NPand 尾 -CTXNMID decreased significantly. After 1 year of treatment, L2L + L3 + L4 + L4 + L4 + + + 1-4 + + + / L + + / L + + / L _ 2 / L _ 3 / L _ 2 / L _ 3 / L _ 2 / L _ 3 / L _ 3 / L _ 3 / L. N-MID in the secondary osteoporosis group was significantly lower than that in the primary osteoporosis group (P 0.01). There was no significant difference between the two groups in bone mineral density, bone metabolism marker P1NPand 尾 -CTX 25 hydroxyvitamin D and PTH levels before and after treatment. No new fractures were found in both groups during the treatment. 2 cases of fever occurred in the primary osteoporosis group, 3 cases in the secondary osteoporosis group, and 3 cases in the secondary osteoporosis group, and 2 cases in the primary osteoporosis group, 3 cases in the secondary osteoporosis group, and 3 cases in the secondary osteoporosis group. Conclusion Zoledronic acid treatment for female osteoporosis patients with different causes can effectively improve bone metabolism markers, reduce bone resorption, significantly increase bone mineral density of lumbar vertebrae and hip. Reduction of fracture risk and less adverse reactions.
【作者单位】：第二军医大学附属长海医院风湿免疫科;
【分类号】：R580

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