中国骨质疏松杂志

绝经后骨质疏松利塞膦酸钠及钙尔奇D治疗临床观察

Clinical observation of the efficacy of sodium risedronate and vitamin D on the treatment of postmenopausal osteoporosis

DOI：10.3969/j.issn.1006-7108.2020.07.020

中文关键词: 钙尔奇D片利塞膦酸钠绝经后骨质疏松症 25羟维生素D 尿脱氧吡啶酚

英文关键词:Caltrate D risedronate sodium postmenopausal osteoporosis 25-(OH)D deoxypyridinoline

基金项目:

作者	单位
吕永美* 李承文	济南市章丘区人民医院，山东济南 250200

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中文摘要:

目的观察钙尔奇D片联合利塞膦酸钠治疗女性绝经后骨质疏松症(postmenopausal osteoporosis，PMOP)患者的效果及对血清尿脱氧吡啶酚(deoxypyridinolinr，DPD)、25 羟维生素D［25-(OH)D］水平的影响。方法选取我院于2016年6月至2018年6月收治的120例PMOP患者，依据随机数字表法分为观察和对照两组，每组60例，对照组给予钙尔奇D片，而观察组给予钙尔奇D片联合塞膦酸钠。比较两组患者的股骨颈和腰椎的骨密度、疼痛视觉模拟量表(VAS)评分以及不同时间点血清DPD、25-(OH)D水平，统计分析两组不良反应发生情况。结果两组患者经治疗后VAS评分显著降低，其中观察组患者VAS评分在治疗后3、6、12个月的改善程度均优于对照组（P＜0.05）。两组患者治疗后右股骨颈、腰椎正位(L2-L4)以及Ward’s区骨密度均显著增加，其中观察组患者在治疗后第6、12个月的骨密度均显著高于对照组（P＜0.05）。两组患者治疗后血清DPD、BGP、NTX、BAP水平显著降低，而血清25-(OH)D水平显著增加，观察组患者在治疗12个月后的各指标血清水平均显著优于对照组（P＜0.05）。骨折事件主要为股骨颈骨折以及腰椎压缩性骨折，其中观察组骨折事件发生率显著低于对照组（P＜0.05）。结论钙尔奇D片联合利塞膦酸钠治疗PMOP疗效显著，可有效降低疼痛，改善改善骨质代谢和血清DPD、25-(OH)D水平，促进骨形成和提高骨密度，从而减少骨折风险。

英文摘要:

Objective To observe the efficacy of Caltrate D combined with risedronate sodium in the treatment of postmenopausal osteoporosis (PMOP) patients and its effect on serum levels of deoxypyridinoline (DPD) and 25-(OH)D. Methods One hundred and twenty female patients with PMOP were treated in our hospital from June 2016 to June 2018 and were divided into observation group and control group according to random digital table, with 60 cases per group. Patients in the control group received Caltrate D only, while patients in the observation group received Caltrate D combined with sodium risedronate. Bone mineral density of the femoral neck and lumbar spine, VAS score, and serum levels of DPD and 25- (OH) D at different time points were compared between the two groups. The occurrence of adverse reactions in the two groups was statistically analyzed. Results The VAS score in the two groups decreased significantly after the treatment. The VAS score in the observation group was better than that in the control group at 3, 6, and 12 months after the treatment. Bone mineral density of the right femoral neck, lumbar spine (L2-4), and Ward’s area in the two groups increased significantly after the treatment. The bone mineral density of the patients in the observation group was significantly higher than that in the control group at 6 and 12 months after the treatment (P<0.05). After the treatment, the serum levels of DPD, BGP, NTX, and BAP significantly decreased, while the serum level of 25-(OH) D significantly increased in the two groups, and the levels in the observation group were significantly higher than those in the control group at 12 months after treatment (P<0.05). The main fracture events were femoral neck fracture and lumbar vertebral compression fracture. The incidence of fracture events in the observation group was significantly lower than that in the control group (P<0.05). Conclusion Caltrate D combined with risedronate is effective in the treatment of PMOP, which can effectively reduce pain, improve bone metabolism and serum DPD,25-(OH)D level, promote bone formation and increase bone mineral density, thus reducing the risk of fractures.

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