唑来膦酸对系统性红斑狼疮合并骨质疏松患者骨密度及骨代谢的影响

发布时间：2018-04-05 20:08

  本文选题：唑来膦酸　切入点：系统性红斑狼疮　出处：《中国药房》2017年02期

【摘要】：目的:探讨唑来膦酸对系统性红斑狼疮(SLE)合并骨质疏松患者骨密度(BMD)及骨代谢的影响。方法:收集2012年3月-2015年1月在我院治疗并自愿参加本研究的70例SLE合并骨质疏松患者的临床资料,按治疗方案不同分为观察组和对照组,各35例。两组患者均给予泼尼松和羟氯喹以维持治疗SLE,对照组患者在此基础上加用钙剂及骨化三醇等传统抗骨质疏松药物进行治疗;观察组患者在对照组基础上加用唑来膦酸注射液4 mg,ivgtt,滴注时间30 min,每年1次,治疗3年。记录两组患者治疗前及治疗1年后腰椎、股骨颈、大转子和Ward’s三角区的BMD,治疗前和治疗1周及1年后血清中钙、磷、Ⅰ型胶原羧基端肽β特殊序列(β-CTx)、N端中段骨钙素(N-MID-OT)、骨特异性碱性磷酸酶(B-ALP)水平,以及治疗过程中的并发症情况。结果:两组患者治疗前上述各项指标比较,差异均无统计学意义(P0.05)。治疗1年后,两组患者各部位BMD水平均明显提高,且观察组患者各部位BMD水平明显高于对照组,差异均有统计学意义(P0.05)。治疗1年后,两组患者血磷、血钙水平及对照组患者血清β-CTx、N-MID-OT、B-ALP水平与治疗前比较,差异均无统计学意义(P0.05);观察组患者血清β-CTx、N-MID-OT、B-ALP水平明显低于治疗前及对照组,差异均有统计学意义(P0.05)。观察组与对照组患者治疗1年内骨折及股骨头坏死的发生率分别为5.71%和25.71%,差异有统计学意义(P0.05)。结论:唑来膦酸可有效减轻SLE合并骨质疏松患者骨吸收程度,降低骨代谢率,提高BMD,减少骨折及股骨头坏死的风险。
[Abstract]:Objective: to investigate the effect of zoledronic acid on bone mineral density (BMD) and bone metabolism in patients with systemic lupus erythematosus (SLE) and osteoporosis.Methods: the clinical data of 70 patients with SLE complicated with osteoporosis who were treated in our hospital from March 2012 to January 2015 were collected and divided into observation group (35 cases) and control group (35 cases).Both groups were treated with prednisone and hydroxychloroquine to maintain the treatment of SLE.The patients in the control group were treated with traditional anti-osteoporosis drugs such as calcium and ossifying triol.Patients in the observation group were treated with zoledronic acid injection 4 mg / g iv gtt for 30 minutes once a year for 3 years.BMDs of lumbar spine, femoral neck, greater trochanter and Ward's triangle were recorded before treatment and 1 year after treatment. Serum calcium and phosphorus were recorded before treatment and 1 week and 1 year after treatment.The specific sequence of carboxyl terminal peptide 尾 (尾 -CTxX) of collagen type 鈪，

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