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| 胰岛素、阿仑膦酸钠治疗新诊断老年糖尿病骨质疏松症患者骨密度及骨转换指标的研究 |
| Effect of insulin and alendronate sodium on bone transition and bone mineral density in aged patients with newly diagnosed type 2 diabetes mellitus with osteoporosis |
| 投稿时间：2013-04-08 |
| DOI： |
| 中文关键词: 胰岛素 阿仑膦酸钠 骨转换指标 骨密度 糖尿病骨质疏松症 |
| 英文关键词:Insulin Alendronate sodium Bone turnover marker Bone density Type 2 diabetes mellitus with osteoporosis |
| 基金项目: |
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| 中文摘要: |
| 目的：通过观察胰岛素、阿仑膦酸钠干预，观察在糖尿病骨质疏松症治疗12个月后股骨颈（ Femur Neck ）骨密度（BMD）及骨特异性碱性磷酸酶（BAP）、骨钙素（BGP）、抗酒石酸酸性磷酸酶-5b（TRAP-5b）等血清骨转换指标的变化。方法选取在我院治疗的糖尿病骨质疏松症患者128例，随机分成4组，即对照组（ METF）、胰岛素组（ INSU）、二甲双胍＋阿仑膦酸钠组（ METF＋ALEN）、胰岛素＋阿仑膦酸钠组（ INSU＋ALEN），每组同时服用钙尔奇D片作为基础用药，分别于服药前及服药12月后，测定4组患者股骨颈BMD及血BAP、BGP、TRAP-5b，分析治疗前后以及治疗组与对照组间的差异。结果 INSU＋ALEN组治疗12月可见患者骨密度较前增加，治疗前后有统计学意义（ P＜0.05）， METF、INSU组较前无明显改变，治疗前后无统计学意义（P＞0.05），METF＋ALEN组治疗12月可见患者BMD较前略有增加，治疗前后无统计学意义（P＞0.05），INSU＋ALEN组治疗后BMD的增加明显高于其它组（P均＜0.05）。 INSU＋ALEN治疗组患者治疗12月后血清BAP、BGP显著升高（P＜0.05），TRAP-5b显著降低（P＜0.05）；将上述指标与对照组、其它治疗组比较， BAP、BGP、TRAP-5b差异显著（P均＜0.01）；METF、INSU、METF＋ALEN组治疗12月可见患者血清BAP、BGP较前略有增加，TRAP-5b略有降低，治疗前后无统计学意义（P＞0.05）。结论胰岛素是糖尿病骨质疏松症首选治疗，可增加骨量，预防骨丢失。阿仑膦酸钠能抑制骨吸收，促进骨形成，减缓骨量丢失，提高骨密度，二者联用可有效防治糖尿病骨质疏松症。 |
| 英文摘要: |
| Objective To observe the intervention of insulin and alendronate sodium, and to investigate the changes of bone specificity alkaline phospha-tase (BAP), tartrate-resistant acid phosphatase-5b (TRAP-5b), osteocalcin (BGP), and the bone mineral density ( BMD) of the femur neck in diabetes patients with osteoporosis after 12-month treatment.Methods One hundred and twenty-eight senile patients with osteoporosis, who were treated in our hospital, were selected and randomly divided into 4 groups:control group ( METF) , insulin group ( INSU) , metformin +alendronate sodium group ( METF +ALEN) , and insulin+alendronate sodium group ( INSU +ALEN) .At the same time, Caltrate D was given as a basic treatment.BMD of the femoral neck and the serum levels of BAP, BGP, and TRAP-5b were detected before the treatment and 12 months after the treatment.And the results were analyzed.Results After 12-month treatment, BMD in INSU +ALEN group increased compared with that before the treatment (P<0.05), while no significant change in METF group and INSU group was observed (P>0.05). BMD of the femoral neck in METF +ALEN group increased slighthly without significant difference (P>0.05).BMD in INSU +ALEN group increased more significantly compared with that in other groups (P<0.05).After 12-month treatment, the levels of BAP and BGP in INSU +ALEN group increased obviously, while the level of TRAP-5b decreased significantly (P <0.05). Compared with that in control group and other treatment groups, the difference was significant (P<0.01).In METF group, INSU group, and METF +ALEN group, the serum levels of BAP and BGP increased slightly after 12-month treatment, while serum TRAP-5b level decreased slightly (P>0.05).Conclusion Insulin is the first choice in the treatment of diabetes mellitus-induced osteoporosis, which can increase bone mass and prevent bone from loss.Alendronate sodium can inhibit bone resorption, promote bone formation, retard the bone mass loss, and raise BMD.The combination of both drugs can prevent and treat diabetes mellitus-induced osteoporosis effectively. |
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