鲑鱼降钙素、α维生素D_3和碳酸钙联合应用对老年脑卒中患者肢体瘫痪后骨质疏松的预防  

Combined application of salmon calcitonin see calcimar, alpha vitamin D_3 and calcium carbonate for prevention of osteoporosis after limb paralysis in senile patients with stroke

作　　者：解旭东[1] 冀凤云[1] 汪明慧[1] 刘建辉[1] 王英[1] 邵莹晖[1] 

机构地区：[1]解放军第二五二医院神经内科,河北省保定市071000

出　　处：《中国临床康复》2005年第33期10-12,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:通过测量第1腰椎正位、双侧股骨颈及双侧桡骨远端骨密度,评价鲑鱼降钙素、α维生素D3与碳酸钙联合治疗在预防老年脑卒中患者肢体瘫痪后骨质疏松中的作用。方法:选择2000-12/2003-12在解放军第二五二医院神经内科收治的老年脑卒中患者364例,随机分为治疗组与对照组。①治疗组予鲑鱼降钙素,50IU,肌注,1次/周;α维生素D3,0.25μg,口服,1次/d;碳酸钙,0.15g,口服,3次/d;另予抗血小板、神经营养药物、活血化瘀治疗等,共治疗1年。②对照组不予鲑鱼降钙素、α维生素D3与碳酸钙,其余治疗同治疗组,共治疗1年。③治疗前后采用DEXA双能X线骨密度仪测量第1腰椎正位、双侧股骨颈及双侧桡骨远端骨密度。结果:105例患者由于未能坚持治疗等原因退出实验,其余259例(治疗组89例,对照组170例)进行结果分析。①治疗组治疗1年后第1腰椎、股骨颈(健侧)、股骨颈(患侧)、桡骨(健侧)骨密度均较治疗前明显升高,分别为7.2%,6.1%,4.9%,3.0%(P<0.05～0.001);桡骨(患侧)骨密度较治疗前升高幅度不大(P>0.05)。②对照组治疗1年后各部位骨密度均明显降低,分别为-2.8%,-2.5%,-10.2%,-3.9%和-11.3%(P<0.01～0.001)。③治疗后治疗组各部位骨密度明显高于对照组[第1腰椎:(0.891±0.066),(0.801±0.060)g/cm2;股骨颈(健侧):(0.915±0.023),(0.846±0.078)g/cm2;股骨颈(患侧):(0.887±0.120),(0.771±0.083)g/cm2;桡骨(健侧)(0.609±0.057),(0.564±0.036)g/cm2;桡骨(患侧):(0.595±0.095),(0.522±0.076)g/cm2,P均<0.001]。结论:联合应用鲑鱼降钙素、α维生素D3与碳酸钙可明显增加患者第1腰椎、双侧股骨颈、双侧桡骨的骨密度,以患侧股骨颈及桡骨增加最明显,预防老年脑卒中患者肢体瘫痪后骨质疏松有较好效果。AIM： Through measuring the bone mineral density of orthophoria and double side neck of femur of the first lumbar vertebra and double side distal radius, to evaluate the effects of the associated application of salmon calcitonin see calcimar, alpha vitamin D3 and calcium carbonate on prevention of osteoporosis after limb paralysis in senile patients with stroke. METHODS： 364 patients with senile stroke who treated in Department of Neurology of the 252 Hospital of Chinese PLA between December 2000 and December 2003 were selected and assigned randomly into treatment group and control group. ① The patients in treatment group were given 50 IU salmon calcitonin see calcimar injected into muscle once a week; 0.25μg alpha vitamin D3 taken orally once a day; 0.15 g calcium carbonate taken orally three times a day; besides the treatment like anti-blood platelet, neural nutrient drug, promoting blood circulation by removing blood stasis etc. was offered for treating one year. ② The patients in control group did not treat with salmon calcitonin see calcimar, alpha vitamin D3 and calcium carbonate, and other treatment were the same to treatment group for treating one year. ③ The bone mineral density of orthophoria and double side neck of femur of the first lumbar vertebra and double side distal radius was measured before and after treatment with dual-energy X-ray absorptiometry. RESULTS：105 patients exited the experiment, for could not persist in the treatment etc., other 259 patients were involved in the result analysis （treatment with 89 cases, and control group with 170 cases）.① The bone mineral density of the first lumbar vertebra, neck of femur （uninjured side）, neck of femur （injured side）, and radius （uninjured side） in treatment group one year after treatment was significantly higher than that before treatment, 7.2%, 6.1%, 4.9%, 3.0% （P 〈 0.05-0.001） respectively; The bone mineral density of radius （injured side） was little higher than before treatment （P 〉 0.05）. ② The

关 键 词：脑血管意外 老年人 骨质疏松 鲑 降钙素 骨化醇类 骨密度 

分 类 号：R743.3[医药卫生—神经病学与精神病学]