PTH和ALN对绝经后骨质疏松患者身体成分的影响

发布时间：2018-03-28 05:09

本文选题：PTH　切入点：阿仑膦酸钠　出处：《重庆医科大学》2016年硕士论文

【摘要】：目的:PTH是调节骨代谢的重要内分泌激素,重组人甲状旁腺素主要用于治疗绝经后骨质疏松;ALN是经典的抗骨质疏松药物,治疗绝经后骨质疏松症效果良好。近年来相关研究提示PTH和ALN不仅影响骨代谢,还可能与脂肪组织的改变有关。本试验观察了重组人甲状旁腺素和阿仑膦酸钠对绝经后骨质疏松患者身体成分的改变。方法:绝经后骨质疏松患者64例随机分为两组(PTH组42例,ALN组22例),分别接受PTH1-34皮下注射20μg/次、每日一次和ALN口服70mg/次、每周一次,治疗48周,采用双能X线骨密度仪检测身体成分。结果:PTH组全身脂肪百分比增加,其中皮下脂肪组织的增加主要以上肢、腰部为主,内脏脂肪含量明显增加;ALN组全身脂肪百分比也较前增加,其中以躯体脂肪增加为主,上下肢、腰臀部以及内脏脂肪组织变化均无统计学差异;两组的肌肉组织较治疗前减少。基线水平时血清PTH水平与BMI、体重、全身脂肪、躯体脂肪、腰部脂肪、臀部脂肪及内脏脂肪呈正相关,PTH与肌肉组织及骨矿物含量无明显相关性。结论:绝经后骨质疏松患者予以PTH治疗后上肢、腰部等皮下脂肪以及内脏脂肪重量增加,予以ALN治疗后脂肪组织无明显变化;无论予以PTH或ALN治疗,绝经后骨质疏松患者的肌肉组织重量均减少。绝经后骨质疏松患者血清PTH水平与BMI、体重及脂肪组织相关。
[Abstract]:Objective to investigate the role of the recombinant human parathyroid hormone in the treatment of postmenopausal osteoporosis (ALN), which is an important endocrine hormone regulating bone metabolism. The treatment of postmenopausal osteoporosis is effective. Recent studies suggest that PTH and ALN not only affect bone metabolism, The effects of recombinant human parathyroid hormone and alendronate on the body composition of postmenopausal osteoporosis patients were observed. Methods: 64 postmenopausal patients with osteoporosis were randomly divided into two groups. PTH1-34 was injected subcutaneously for 20 渭 g / time in 42 cases of ALN group in both groups, and 22 cases in group A were given subcutaneous injection of PTH1-34. Once a day and once a week, ALN was treated with 70mg/ once a week for 48 weeks, and the body composition was detected by dual energy X-ray absorptiometry. Results the percentage of body fat in the group of ALN increased, and the increase of subcutaneous adipose tissue was mainly in upper limb and waist. The percentage of body fat in ALN group was significantly higher than that in the previous group. The increase of body fat was the main factor, but there was no significant difference in the changes of upper and lower limbs, waist and hip, and visceral adipose tissue in ALN group. The muscle tissue of the two groups was lower than that before treatment. At baseline, serum PTH levels were associated with BMI, body weight, body fat, body fat, waist fat, There was no significant correlation between hip fat and visceral fat. Conclusion: the weight of subcutaneous fat and visceral fat in postmenopausal osteoporosis patients increased after PTH treatment. There was no significant change in adipose tissue after ALN treatment, but the weight of muscle tissue in postmenopausal osteoporosis patients decreased regardless of PTH or ALN treatment. The serum PTH level in postmenopausal osteoporosis patients was correlated with BMI, body weight and adipose tissue.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R580

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