阿伦膦酸盐预防激素相关性骨量丢失的前瞻性研究  

The prospective study of alendronate on prevention of corticosteroid-induced osteoporosis

作　　者：万伟国[1] 郑舒聪[1] 张锦明[2] 邹和建[1] 

机构地区：[1]复旦大学附属华山医院风湿科,上海200040 [2]复旦大学附属华山医院核医学科,上海200040

出　　处：《临床内科杂志》2008年第5期330-332,共3页Journal of Clinical Internal Medicine

摘　　要：目的研究阿伦膦酸盐预防激素相关性骨质疏松的作用。方法将21例需要长期服用糖皮质激素的风湿病患者随机分为治疗组和对照组。对照组在应用糖皮质激素治疗同时给予乐力(氨基酸鳌合钙加维生素D)1粒,每天2次,口服;治疗组在对照组药物的基础上,加用阿伦膦酸盐10mg,每天1次或70mg,每周1次,口服。所有患者在治疗前和治疗后3、6、12月,应用双能X线吸收法测定腰椎及股骨颈的骨密度(BMD)。结果对照组在糖皮质激素治疗后3、6、12个月BMD与自身治疗前比较明显下降(P<0.01);治疗组腰椎的BMD与自身治疗前比较有上升趋势(12个月时有统计学差异,P<0.05),股骨颈的BMD治疗后3、6个月与自身治疗前比无变化(P>0.05),12个月有轻度降低(P<0.05)。结论单予钙剂加维生素D不能有效预防糖皮质激素相关性骨质疏松的发生,加用阿伦膦酸盐则可有效延缓糖皮质激素相关性骨量丢失。Objective To study the prevention of alendronate in corticosteroid-induced osteoporosis patients. Methods 21 cases of rheumatic patients treated with glucocorticoid were randomized into two groups ：a control group receiving Osteoform （compound calcium amino acid chelate and Vitamin D） and a comprehensive therapy group receiving alendronate as welll as Osteoform. Dual-enengy X-ray absorptionmerry were carried out before and after medication at 3rd ,6 th and 12 th month. Results Lumbar spine and femur BMD decreased at 3 rd,6 th and 12 th month in control group （P 〈 0.01 ）, however, no change of BMD happened in therapy group at 3 rd and 6 th month （ P 〉 0.05 ）. Conclusions Comprehensive therapy of alendronate can prevent corticosteroid-induced osteoporoses, which simplex treatment can not.

关 键 词：骨密度 糖皮质激素 阿伦膦酸盐 骨质疏松 风湿性疾病 

分 类 号：R580[医药卫生—内分泌]