阿仑膦酸钠治疗绝经后骨质疏松症空腹尿钙和尿肌酐及其比值变化特点  

Assessing Clinical Features of the Fasting Urine Calcium,Urine Creatinine and Their Ratio in the Postmenopausal Osteoporosis with Alendronate Management

作　　者：杨红斌[1] 朱庆文[2] 喻战军[1] 胡朝晖[1] 刘忠厚[3] 

机构地区：[1]浙江省衢州市人民医院内分泌代谢科,324000 [2]浙江省衢州市人民医院检验科,324000 [3]中国老年学会骨质疏松委员会

出　　处：《中国全科医学》2009年第12期1051-1053,共3页Chinese General Practice

基　　金：国家民政部十一五期间老年学会研究科研立项项目课题:民人教科家(2007)18-1-33

摘　　要：目的研究阿仑膦酸钠治疗绝经后骨质疏松症空腹尿钙、尿肌酐及其比值变化特点和临床价值。方法应用双能X线骨密度仪筛查102例绝经后骨质疏松症患者(45～69岁),每周70mg阿仑膦酸钠治疗半年,分别在治疗前和治疗后3个月、6个月时采用偶氮胂III法和肌氨酸氧化酶法测定空腹尿钙和尿肌酐,同时检测月经周期正常的健康女性103例(20～49岁),计算尿钙/肌酐比值。结果绝经后骨质疏松症患者使用阿仑膦酸钠治疗前和治疗3个月、6个月时尿钙检测值、尿钙/肌酐比值间差异均有统计学意义(P<0.01),而尿肌酐水平间差异无统计学意义(P>0.05)。其中尿钙、尿钙/肌酐比值在治疗3个月、6个月时与治疗前比较差异有统计学意义(P<0.01),治疗6个月与3个月时尿钙检测值间差异有统计学意义(P<0.05)。绝经后骨质疏松患者用药前尿钙、尿钙/肌酐比值同健康对照组相比明显升高(P<0.05),治疗6个月时与健康对照组间差异无统计学意义(P>0.05)。结论空腹尿钙和尿钙/肌酐比值均可以作为评估绝经后骨质疏松症患者骨吸收状态的生化指标,也可以作为监测阿仑膦酸钠的疗效指标在临床上使用,尿钙/肌酐比值显得更加稳定;空腹尿肌酐检测无意义。Objective To study the clinical features of the fasting urine calcium(U-Ca),urine creatinine(U-Cr) and their ratio(U-Ca/Cr) in the postmenopausal osteoporosis(PMOP) with alendronate management.Methods 102 PMOP patients aged 45～69 years were identified using dual-energy X-ray absorptiometry(DXA) measurements of the spine and hip bone mineral density.All PMOP cases took alendronate 70 mg once a week for 6 months.The U-Ca and the U-Cr of the spot urine samples were measured at the baseline,3 and 6 months after taking alendronate by Azo arsine III assay and Sarcosine oxidase assay.U-Ca and U-Cr of the fasting urine samples in 103 normal menstrual cycle health women were tested simultaneously with the PMOP,and calculated their U-Ca/Cr.Results The values of U-Ca and U-Ca/Cr at the baseline,3 months,and 6 months after taking alendronate in the PMOP group were statistical significance(P<0.01),but the U-Cr were statistically similar(P>0.05).The U-Ca and U-Ca/Cr at 3 months,and 6 months after taking alendronate in the PMOP group were significantly lower than those at the baseline(P<0.01),and the U-Ca at 6 month spot returned higher than it at 3 month spot(P<0.01).The values of U-Ca and U-Ca/Cr at the baseline in the PMOP group were signicantly higher than the health control(P<0.05),but the both values at 6 month spot restored the health women levels(P>0.05).Conclusion The fasting U-Ca index and U-Ca/Cr ratio may be the best biochemical markers of bone resorption to assess the PMOP bone turnover status,and monitor the effect of treatment with alendronate in the PMOP.The fasting U-Ca/Cr ratio shows more stable than the fasting U-Ca index in the PMOP patients with alendronate thrapy,but the fasting U-Cr index was no clinical significance.

关 键 词：骨质疏松 绝经后 阿仑膦酸钠 尿钙/肌酐比值 

分 类 号：R68[医药卫生—骨科学]