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| 德尼单抗联合鲑鱼降钙素治疗老年性骨质疏松的疗效及对患者骨密度、骨代谢的影响 |
| The efficacy of denizumab combined with calcitonin on the treatment of senile osteoporosis and the influence on bone mineral density and bone metabolism |
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| DOI：10.3969/j.issn.1006-7108.2019.01.009 |
| 中文关键词: 德尼单抗 鲑鱼降钙素 老年骨质疏松 骨密度 骨代谢 |
| 英文关键词:denizumab salmon calcitonin senile osteoporosis bone mineral density bone metabolism |
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| 中文摘要: |
| 目的 探讨德尼单抗联合鲑鱼降钙素治疗老年性骨质疏松的疗效及对患者骨密度、骨代谢的影响。方法 200例老年骨质疏松患者随机分为研究组和对照组，两组患者均日服钙尔奇碳酸钙D片进行基础治疗，对照组采用肌肉注射鲑鱼降钙素。研究组在对照组的基础之上加用德尼单抗。分别在治疗前后评定两组患者视觉模拟疼痛评分(VAS)及(Oswestry功能障
碍指数评分(ODI)；检测患者骨密度及骨碱性磷酸酶骨人交联碱性磷酸酶( BALP ) , I型胶原N末端肽/肌酐(I型胶原N-端肽)肌酸酐( NTX/Cr)，骨钙素(BGP)和β-胶原降解产物(β-CrossLaps)。结果 治疗前，两组患者VAS和ODI评分无统计学意义(P>0.05)。治疗后，两组患者的VAS和ODI评分较治疗前均有显著改善(P<0.05)，且研究组改善程度明显优于对照组( P<0. 05) ;治疗前，两组患者腰椎(L2-4)、股骨颈、大转子以及全髓BMD无统计学意义(P>0.05)，治疗后，两组患者腰椎(L2-4)、股骨颈、大转子以及全髓BMD较治疗前均显著改善(P<0.05)，且研究组明显优于同期对照组(P<0. 05 )；治疗前，两组患者BALP,NTX/Cr,BGP以及β-CrossLap、水平比较无统计学意义(P>0.05 )。治疗后，两组患者BALP,NTX/Cr,BGP较治疗前均明显上升(P<0.05)，研究组明显高于对照组(P<0.05)，而两组患者β-CrossLap、水平较治疗前均明显下降(P<0.05)，研究组明显低于对照组(P<0.05 );两组患者治疗前后肝肾功能、尿、血以及粪常规均无明显变化，且在研究过程中均未出现不良情况。结论 德尼单抗联合鲑鱼降钙素能够显著改善老年骨质疏松患者的骨密度和骨代谢指标，能够有效缓解患者的疼痛和功能障碍。 |
| 英文摘要: |
| Objective To study the effect of denizumab combined with calcitonin treatment on senile osteoporosis and its influence in bone mineral density(BMD) and bone metabolism. Methods Two hundred senile osteoporosis patients were randomly divided into research group and the control group. Patients in both groups received oral calcium carbonate D for foundation treatment. Patients in control group received salmon calcitonin intramuscularly. Patients in research group received denizumab in addition to the treatment in control group. The visual simulation pain score(VAS)and Oswestry dysfunction index score(ODI) were used to evaluate the patients before and after the treatment, respectively. BMD, bone alkaline phosphatase(BALP)，N terminal peptide/creatinine of collagen type I(NTX/Cr)，osteocalcin(BGP)，and β-collagen degradation products(β-CrossLaps)were determined. Results Before the treatment, there was no statistically significant difference of VAS and ODI scores between the two groups(P> 0. 05).After the treatment, both VAS and ODI scores in the two groups were significantly improved compared with those before treatment(P<0.05)，and the improvement of the research group was significantly better than that of the control group (P< 0.05).Before the treatment, BMD of the lumbar spine(L2-4)，femoral neck, great trochanter, and total hip in patients of two groups was not statistically significant(P>0.05).After the treatment, BMD of the lumbar spine(L2-4)，femoral neck, great trochanter, and total hip two groups in patients of two groups significantly improved than that before the treatment(P< 0. 05)，and the improvement of the research group was significantly better than that of the control group(P < 0.05).Before the treatment, the levels of BALP, NTX/Cr, BGP, and β-CrossLaps were not statistically significant between the two groups(P>0.05).After the treatment, BALP, NTX/Cr, and BGP in patients of both groups increased significantly(P< 0.05)，and the increase in the research group was significantly higher than those in the control group(P < 0. 05). β-CrossLaps level in both groups decreased significantly than that before the treatment(P<0. 05)，and it was obviously lower in the research group than in the control group(P< 0. 05). There were no significant changes in liver and kidney function, urine, and blood and fecal routine before and after the treatment in both groups. No adverse events occurred during the study. Conclusion Denizumab combined with calcitonin significantly improves BMD and bone metabolism index in elderly patients with osteoporosis and effectively relieves the pain and dysfunction of the patients. |
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