围绝经期2型糖尿病骨质疏松症治疗中胰岛素与阿仑膦酸钠的联合应用效果观察

发布时间：2019-02-15 11:28

【摘要】：目的观察围绝经期2型糖尿病骨质疏松症治疗中胰岛素与阿仑膦酸钠的联合应用效果。方法 168例围绝经期2型糖尿病骨质疏松症患者,随机分为胰岛素+阿仑膦酸钠组、胰岛素组、阿仑膦酸钠组、对照组,每组42例。各组均口服骨化三醇胶丸0.25μg+碳酸钙D3 600 mg+二甲双胍1 500 mg/d口服,1次/d。胰岛素+阿仑膦酸钠组,胰岛素0.5 IU/(kg.d)皮下注射,2次/d,口服阿仑膦酸钠70 mg,1次/周;胰岛素组使用胰岛素早晚餐前皮下注射,剂量为0.5 IU/(kg.d);阿仑膦酸钠组口服阿仑膦酸钠70 mg,1次/周。共治疗12个月。治疗前、后采用测定各组腰椎和全髋骨密度(BMD)。治疗前、后抽取各组空腹静脉血5 mL,采用自动生化分析仪检测空腹血糖,采用美国RAD公司试剂盒检测糖化血红蛋白(HbA_(1c)),采用ELISA法检测血清骨保护素(OPG),采用酶联免疫法检测Ⅰ型胶原C端肽(CTX)。结果与治疗前比较,治疗后胰岛素+阿仑膦酸钠组腰椎、全髋BMD增加(P均0.05);与胰岛素组、阿仑膦酸钠组、对照组治疗后比较,胰岛素+阿仑膦酸钠组腰椎、全髋BMD增加(P均0.05)。与治疗前比较,治疗后各组空腹血糖、HbA_(1c)均降低(P均0.05)。与治疗前比较,治疗后胰岛素+阿仑膦酸钠组血清OPG水平升高、CTX水平降低(P均0.05);与胰岛素组、阿仑膦酸钠组、对照组治疗后比较,胰岛素+阿仑膦酸钠组OPG水平升高、CTX水平降低(P均0.05)。结论围绝经期2型糖尿病骨质疏松症治疗中胰岛素与阿仑膦酸钠的联合应用效果较好。
[Abstract]:Objective to observe the effect of insulin combined with alendronate in the treatment of type 2 diabetic osteoporosis. Methods 168 cases of peri-menopausal type 2 diabetic osteoporosis were randomly divided into insulin alendronate group, insulin group, alendronate group and control group (42 cases in each group). Each group was treated with 0.25 渭 g calcium carbonate D3 600 mg metformin 1 500 mg/d orally, once a day. In insulin alendronate group, insulin 0.5 IU/ (kg.d) was injected subcutaneously twice a day, and alendronate was given orally for 70 mg,1 / week. The insulin group was subcutaneously injected with insulin in the morning and evening preprandial period (kg.d), and alendronate sodium was administered orally in the alendronate group for 70 mg,1 / week. The treatment lasted 12 months. Before and after treatment, the bone density of lumbar vertebrae and total hip were measured by (BMD). In each group. Before and after treatment, fasting venous blood was extracted for 5 mL, and fasting blood glucose was detected by automatic biochemical analyzer. HbA_ (1c), ELISA method) was used to detect serum osteoprotegerin (OPG), and HbA_ (1c),) was used to detect glycosylated hemoglobin (HbA_). Detection of type I collagen C-terminal peptide (CTX). By enzyme-linked immunosorbent assay Results compared with before treatment, the total hip BMD increased in the insulin alendronate group after treatment (P 0.05). Compared with insulin group, alendronate group and control group, BMD of lumbar vertebrae and total hip in insulin alendronate group increased after treatment (all P 0. 05). Compared with before treatment, fasting blood glucose and HbA_ (1c) in each group were decreased after treatment (P < 0. 05). Compared with before treatment, serum OPG level increased and CTX level decreased in insulin alendronate group after treatment (all P 0. 05). Compared with insulin group, alendronate group and control group, OPG level increased and CTX level decreased in insulin alendronate group. Conclusion the combination of insulin and alendronate is effective in the treatment of type 2 diabetic osteoporosis.
【作者单位】：深圳市第二人民医院;
【基金】：深圳市科技研发资金项目资助项目(JCYJ20150330102720148) 深圳市卫生计生系统科研项目(201506021)
【分类号】：R580;R587.1

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