骨质疏松伴膝骨性关节炎临床治疗的研究  

Clinical study of treatment on osteoporosis with osteoarthritis on knee

作　　者：林华[1] 韩祖斌[1] 陈新[1] 张咏梅[1] 李卫国[1] 

机构地区：[1]南京大学医学院附属鼓楼医院骨病中心,南京210008

出　　处：《中国骨质疏松杂志》2005年第4期473-475,484,共4页Chinese Journal of Osteoporosis

基　　金：南京市医学科技重点发展基金(ZKG9913)

摘　　要：目的研究探讨骨化三醇、非甾类药物及钙剂对骨质疏松伴膝骨性关节炎的骨量,骨超声,骨痛及骨质增生的治疗作用。方法200例女性骨质疏松伴膝骨性关节炎患者随机分成两组,A组,瑞力芬(中美史克)1.0g,每晚1次,连续服用20d;罗钙全(上海罗氏)0.25μg,每天1次,连续服用1年。B组:瑞力芬1.0g,每晚1次,连续服用20d;钙尔奇D(惠氏白宫)600mg,每天1次,连续服用1年。比较关节疼痛强度、腰椎骨密度(L14)、跟骨超声骨强度及关节骨质增生的变化。结果两组患者治疗后患膝疼痛和全身情况均有明显改善,但缓解持续时间有显著不同,A组明显优于B组;A组患者经治疗后,腰椎骨密度和跟骨骨强度(SOS,BUA)均有提高;B组患者治疗后腰椎骨密度和跟骨骨强度仍有下降。结论骨化三醇联合非甾类药物对骨质疏松伴膝骨性关节炎有较好的治疗作用,骨化三醇不仅可促进成骨细胞的功能,提高骨质量,而且能加强肌肉力量,提高关节的稳定性。Objective To study the treatment effect of 1, 25 （OH）2D3, NSAID and calcium on osteoporosis with knee osteoarthritis. Methods Two hundred female patients diagnosed osteoporosis with osteoarthritis on knee were randomly divided into two groups. Group A were treated with Nabumetone（GSK）1.0 g, once per night for 20 days and Rocaltrol（ Roche）0.25μg, once daily for one year. Group B received the same Nabumetone as group A and Caltrate（Wyeth Pharm）600 mg,once daily for one year. The different changes of arthralgic intensity,lumbar BMD （L1-4） and calcaneus QUS between these two groups were compared. Results Both groups had significant improvement in knee arthralgia and medical condition after treatments. However, the duration of alleviation in group A was longer than that of group B. Lumbar BMD and calcaneus QUS （ SOS, BUA） increased in Group A, while decreased in Group B after treatment. Conclusions Calcitriol in combination with NSAID has good effect on osteoporosis with osteoarthritis on knee. 1,25 （OH）2D3, as a bone metabolic regulator, not only promotes the function of osteoblast, but also increases bone quality, as well as strength of bone, muscle force and articular stability.

关 键 词：骨质疏松 骨化三醇 非甾类药物 骨密度 超声 膝骨性关节炎 

分 类 号：R684.3[医药卫生—骨科学] R681[医药卫生—外科学]