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| 鲑鱼降钙素联合阿仑膦酸钠治疗老年性骨质疏松的部分机制研究 |
| Study of the efficacy of salmon calcitonin combined with alendronate sodium on senile osteoporosis and the regulation mechanism |
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| DOI：10.3969/j.issn.1006.7108.2015.07.016 |
| 中文关键词: 骨质疏松 鲑鱼降钙素 阿仑膦酸钠 联合用药 1,25-(OH)2D3；PTH |
| 英文关键词:Osteoporosis Calcitonin Alendronate Combined medication 1,25-(OH)2D3 PTH |
| 基金项目:军区医药卫生科研基金（12MA071) |
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| 中文摘要: |
| 目的 观察鲑鱼降钙素联合阿仑膦酸钠对老年骨质疏松的疗效以及探讨其影响骨代谢的调控机制。方法 将本院收治的60例伴有疼痛症状的老年骨质疏松患者，计算机随机分为2组，对照组27例，治疗组33例，对照组口服阿仑膦酸钠70 mg/次/周，治疗组在对照组治疗基础上注射鲑鱼降钙素，50 IU/次，每天，连续7d，第8 d开始以同等剂量隔天注射，第14 d开始同等剂量2次/周，28 d为一个疗程，共6个疗程，检测治疗前后患者疼痛症状、骨密度、血清1，25-( OH)2D3和PTH水平的变化情况。结果 ①两组治疗后腰背痛量化结果均有一定程度的改善;与对照组比较，治疗组VAS等级综合评分显著下降， 差异有统计学意义(P <0.05)，对照组腰背痛VAS等级综合评分均>5，而治疗组评分均< 4;②两组治疗后第14腰椎（L1- L4)和股骨颈、总髋部的骨密度与治疗前相比均具统计学差异（P <0. 05)，其中治疗组治疗后骨密度远高于对照组（P < 0.05);对照组与治疗组在治疗后的T值均显著高于治疗前(P <0.05)，且治疗组显著高于对照组（P <0.05);③治疗后对照组患者血清1，25-( OH)2 D3水平明显低于治疗组(P <0.05)，对照组血清PTH含量明显高于治疗组（P <0.05)。结论 骨质疏松发生发展过程中伴有腰背疼痛，骨密度降低，鲑鱼降钙素联合阿仑膦酸钠可能通过增加1，25-(OH)2D3，抑制PTH的合成来改善骨质疏松症状。 |
| 英文摘要: |
| Objective To observe the efficacy of salmon calcitonin combined with alendronate sodium on the treatment of senile osteoporosis and to explore its mechanism of regulation of bone metabolism. Methods Sixty elderly patients with osteoporosis were divided into two groups，27 cases in the control group and 33 cases in the treatment group. The patients in control group received 70mg alendronate per day. The patients in the treatment group received intramuscular injection of 50 IU/day salmon for 7 days，and every other day from the eighth day，and twice weekly from the fourteenth day，besides the alendronate treatment. One treatment course was 28 days，and the treatment lasted for 6 courses. The pain symptom before and after treatment，bone mineral density (BMD)，serum 1,25-(OH)2D3，and PTH were detected. Results 1) The back pain in patients of both groups relieved after the treatment. Comparing to that in control group (VAS >5)，VAS in the treatment group (VAS <4) decreased significantly (P <0. 05). 2) After the treatment，BMD of the lumbar spine (L1-L4)，femoral neck，and total hip was different comparing to that before the treatment in both groups (P < 0. 05). BMD was much higher in the treatment group than that in control group (P < 0.05). T value after the treatment was significantly higher than that before the treatment in both groups，and it was higher in the treatment group than in control group. 3) After the treatment，serum 1,25-(OH) 2D3 was significantly lower in control group than in the treatment group，but PTH content was significantly higher in control group (P <0.05). Conclusion The back pain and decrease of BMD occur during the development process of osteoporosis. Salmon calcitonin combined with alendronate sodium elieves the symptom of osteoporosis by increasing 1,25-( OH) 2D3 and inhibiting PTH synthesis. |
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