帕米磷酸钠静脉注射联合钙剂和维生素D:有效治疗炎症性肠病引起的骨矿质密度降低  

Intravenous pamidronate in combination with calcium and vitamin D: Highly effective in the treatment of low bone mineral density in inflammatory bowel disease

作　　者：Stokkers P. C. F. Deley M. Van Der Spek M. 王铮(译) 王晓君(校) 

机构地区：[1]Academic Medical Center, Department of Gastroenterology, C2-220, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands [2]不详

出　　处：《世界核心医学期刊文摘（胃肠病学分册）》2006年第8期57-57,共1页Core Journals in Gastroenterology

摘　　要：Objective. Decreased bone mineral density (BMD) is common in inflammatory bowel disease (IBD) and an increased risk of fractures has been reported. Guidelines state bisphosphonate treatment for IBD patients with decreased BMD, but orally available bisphosphonates have been associated with gastrointestinal side effects and the Absorption is poor. We investigated whether intravenous pamidronate is a safe and effective treatment. Material and methods. Forty- nine IBD patients with decreased BMD as assessed by DEXA scan were treated with calcium 1000 mg and vitamin D 400IU daily. In addition, 30 mg of pamidronate was administered intravenously every 3 months. DEXA scanning was performed prior to treatment, after 6 months and after 1 year. Results. Of 49 IBD patients, 40 were osteoporotic and 9 were osteopenic. Twenty- six patients were female (mean age 40.8) and 23 were male (mean age 43.3). Treatment was discontinued in one patient because of fever after infusion. Otherwise, tolerability was excellent, and no adverse events were documented. A mean 0.51 increase of lumbar spine (L1- L4) T- scores was observed (CI 95% 0.35 - 0.67; p < 0.0004). The effect of treatment on left femoral neck T- scores was less pronounced: 0.39 (CI 95% 0.24- 0.53; p < 0.0004). Conclusions. We conclude that intravenous pamidronate in combination with calcium and vitamin D is a well tolerated strategy for treating Crohn’s disease associated osteopenia and osteoporosis. Although uncontrolled, treatment results in a significant increase of BMD in the lumbar spine.Objective. Decreased bone mineral density （BMD） is common in inflammatory bowel disease （IBD） and an increased risk of fractures has been reported. Guidelines state bisphosphonate treatment for IBD patients with decreased BMD, but orally available bisphosphonates have been associated with gastrointestinal side effects and the absorption is poor. We investigated whether intravenous pamidronate is a safe and effective treatment. Material and methods. Forty - nine IBD patients with decreased BMD as assessed by DEXA scan were treated with calcium 1000 mg and vitamin D 400IU daily. In addition, 30 mg of pamidronate was administered intravenously every 3 months. DEXA scanning was performed prior to treatment, after 6 months and after 1 year. Results. Of 49 IBD patients, d0 were osteoporotic and 9 were osteopenic. Twenty -six patients were female （mean age d0.8） and 23 were male （mean age 43.3 ）. Treatment was discontinued in one patient because of fever after infusion. Otherwise, tolerability was excellent, and no adverse events were documented. A mean O. 51 increase of lumbar spine （L1 - L4） T - scores was observed （CI 95% 0. 35 - 0.67; p 〈 0. 0004）. The effect of treatment on left femoral neck T - scores was less pronounced： 0. 39 （CI 95% 0.24 -0.53; p 〈0. 0004）. Conclusions. We conclude that intravenous pamidronate in combination with calcium and vitamin D is a well tolerated strategy for treating Crohn＇ s disease associated osteopenia and osteoporosis.

关 键 词：静脉注射后 帕米磷酸钠 炎症性肠病 有效治疗 维生素D 骨矿质 密度 钙剂 双能X线吸收仪 联合 

分 类 号：R472.9[医药卫生—护理学] R687.5[医药卫生—临床医学]