阿伦膦酸盐联合钙尔奇D对老年女性2型糖尿病骨质疏松患者骨密度的影响  

Therapeutic effects of alendronate combined with Caltrate D on regional bone mineral density in elderly type 2 diabetic women with osteoporosis

作　　者：陈海翎[1] 邓丽丽[1] 李菊芬[1] 

机构地区：[1]北京积水潭医院内分泌科,100035

出　　处：《中华老年医学杂志》2010年第8期652-655,共4页Chinese Journal of Geriatrics

摘　　要：目的 探讨应用阿伦膦酸盐联合钙尔奇D治疗对老年女性2型糖尿病患者不同部位骨质疏松的疗效.方法 选择老年女性2型糖尿病骨质疏松患者34例,年龄60～79岁,平均（68.0±4.5）岁,体质指数（25.0±3.7）kg/cm2,糖尿病病程（8.9±4.4）年.综合治疗基础上,应用阿伦膦酸盐联合钙尔奇D治疗6个月;检测治疗前、后腰椎、髋骨骨密度及血生化指标.结果 治疗后6个月,患者各部位骨密度均增加,腰椎的T值及骨密度均高于髋骨（均P＜0.01）.总体上各个部位间T值及骨密度改善差异均有统计学意义（分别为P=0.003和0.005）.腰椎骨密度改善百分比：L4（44.7%）＞L3（31.9%）＞L总（27.3%）＞L1（20.0%）＞L2（14.3%）,其中L3和L4的骨密度改善百分比显著高于其他腰椎部位（P=0.038,0.008）.L3、L总、L1和L4 T值及骨密度改善显著高于L2（T值：P值分别为0.036、0.042、0.006和0.004,骨密度：P值分别为0.002、0.002、0.003和0.001）.结论 阿伦膦酸盐联合钙尔奇D治疗老年女性2型糖尿病骨质疏松,短期疗效以腰椎下位椎骨较好,髋骨疗效欠佳.Objective To investigate the therapeutic effects of alendronate combined with Caltrate D on regional bone mineral density （BMD） in elderly type 2 diabetic women with osteoporosis. Methods Thirty-four elderly type 2 diabetic women with osteoporosis aged 60-79 years （average 68. 0±4.5 years）, with body mass index （BMI） of （25.0±3.7） kg/cm2 and duration of diabetes （8.9 ±4.4） years were enrolled. At the basis of a comprehensive management, the patients were treated with alendronate combined with Caltrate D for 6 months. BMD of the lumbar spine and hip, several biochemical indexes were measured before and after treatment. Results After the 6 months treatment, the BMD of different regions at lumbar spine and hip all increased. The T value and BMD were significantly higher at lumbar spines than at hip （both P〈0.01）. The differences of T value and BMD of different regions were significant （P = 0.003 and 0.005,respectively）. BMD percent change at lumbar spine were L4 （44.7%） 〉 L3 （31.9%） 〉 L total （27.3 % ） 〉 L1 （20.0%） 〉 L2 （14.3 % ）, and the BMD percent changes were significantly higher in L3 and L4 than in other regions at lumbar spine （P=0. 038 and 0. 008, respectively）. The changes of T value and BMD were significantly higher in L3, L total, L1 and L4 than in L2 （T value： P=0. 036,0. 042, 0. 006 and 0. 004, respectively; BMD： P=0. 002, 0. 002, 0. 003 and 0. 001, respectively）.Conclusions On the basis of comprehensive management, the 6 months treatment with alendronate combined with Caltrate D in elderly type 2 diabetic women with osteoporosis may achieve good therapeutic effect at lumbar spines, especially at the lower lumbar spines, while less effective at hip.

关 键 词：糖尿病 2型 骨质疏松 绝经后 二膦酸盐类 

分 类 号：R580[医药卫生—内分泌]