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| 阿仑膦酸钠对甲状腺功能减患者骨密度及骨生化、代谢影响的临床研究 |
| Clinical study of the effect alendronate on bone mineral density, bone biochemistry, and bone metabolism in patients with hypothyroidism |
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| DOI：10.3969/j.issn.1006.7108.2018.01.011 |
| 中文关键词: 甲状腺功能减 骨密度 阿仑膦酸钠 骨代谢 |
| 英文关键词:Hypothyroidism Bone mineral density Alendronate Bone metabolism |
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| 中文摘要: |
| 目的 观察阿仑膦酸钠对甲状腺功能减患者骨密度及骨生化、代谢影响的影响。方法 初次诊断为未绝经的甲状腺功能减退女性患者64例，按随机数字表法将其分为治疗组32例，对照组32例。对照组给予左旋甲状腺素替代治疗，治疗组在对照组治疗的基础上给予阿仑膦酸钠70mg/周，为期12个月。测定治疗不同时间段患者，腰椎1-4 (L1-4)、左侧股骨颈BMD及血Ca2+、血P3+、1,25-(OH)2D3、碱性磷酸酶(ALP)、血清Ⅰ型胶原羧基端吡啶并啉交联肽(ICTP)以及血清骨钙蛋白(bone gla-protein，BGP)水平的变化情况。结果 治疗前两组患者的骨密度及骨生化、代谢指标比较不具有统计学意义(P>0.05)；治疗12个月后，治疗组患者的腰椎1-4 (L1-4)及股骨颈BMD均显著高于治疗前及同时期对照组(P<0.05)；治疗后12个月后，两组患者的血 ALP、ICTP及BGP均有不同程度升高，治疗组的BGP升高程度明显大于对照组；而对照组的ALP及ICTP升高程度明显大于治疗组，比较有统计学意义(P<0.05)。治疗前后两组患者血Ca2+、血P3+、1,25-(OH)2D3比较无明显差异(P>0.05)。结论 阿仑膦酸钠可以明显提升甲状腺功能减患者骨密度，改善骨生化和代谢状态。 |
| 英文摘要: |
| Objective To observe the effect of alendronate on bone mineral density (BMD), bone biochemistry and metabolism in patients with hypothyroidism. Methods Sixty-four female patients with hypothyroidism were divided into treatment group (32 cases) and control group (32 cases) according to the random number table method. Patients in the control group received L-thyroxine replacement therapy. Patients in the treatment group received alendronate sodium 70mg/week based on the treatment of the control group, for 12 months. BMD of the lumbar vertebrae 1-4 (L1-4) and the left femoral neck and the levels of blood Ca2+, P3+, 1,25- (OH) 2D3, alkaline phosphatase (ALP), serum type I collagen (ICTP), and serum osteocalcin (BGP) were measured. Results BMD, bone biochemistry and metabolic index were not statistically significant between the two groups before the treatment (P>0.05). After 12 months of treatment, BMD of L1-4 and femoral neck was significantly higher in the treatment group than that in the control group and before treatment (P<0.05). After treatment, the levels of ALP, ICTP, and BGP increased in both groups, and the level of BGP in the treatment group was significantly higher than that in the control group. ALP and ICTP increased significantly in the control group than in the treatment group, with statistical significance (P <0.05). There were no significant differences in serum Ca2+, P3+, and 1,25- (OH) 2D3 between the two groups before and after the treatment (P>0.05). Conclusion Alendronate sodium significantly enhances BMD, and improves bone biochemical and metabolic status in patients with hypothyroidism. |
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