雷奈酸锶对骨质疏松性骨痛及骨密度疗效评价  

The evaluation of efficacy of strontium ranelate on osteoporotic bone pain and bone mineral density

作　　者：聂玮[1,2] 李晓林[2] 蒋梁华[2] 曾炳芳[2] 

机构地区：[1]苏州大学,苏州215006 [2]上海市第六人民医院

出　　处：《中国骨质疏松杂志》2011年第5期419-423,共5页Chinese Journal of Osteoporosis

摘　　要：目的研究雷奈酸锶联合钙剂在骨质疏松症治疗中对骨痛、骨密度及骨质疏松性骨折风险的作用,评价其疗效和安全性。方法 124例老年骨质疏松症患者被随机分为雷奈酸锶+钙剂组(SR+Ca组,62例)和钙剂组(Ca组,62例),进行开放、对比研究。雷奈酸锶+钙剂组:雷奈酸锶2g/d,口服,同时口服钙剂600mg/d;Ca组:钙剂600mg/d,口服。治疗前后分别测定两组患者腰背部自发性疼痛的VAS评分、L1-L4椎体、股骨颈、Wards三角、桡骨远端的BMD值及T值,并观察两组骨质疏松性骨折的发生率及服药后的不良反应。结果治疗后雷奈酸锶+钙剂组VAS评分明显改善,低于钙剂组,但骨痛缓解过程较为缓慢;雷奈酸锶+钙剂组L1-L4椎体、股骨颈、Wards三角、桡骨远端的BMD值及T值在治疗后6月及12月较治疗前上升显著,明显优于钙剂组(P<0.01)。骨质疏松脆性骨折的发生率钙剂组明显高于雷奈酸锶+钙剂组。雷奈酸锶的主要不良反应为恶心及腹泻,钙剂组主要为便秘。结论雷奈酸锶对骨痛的缓解作用较为缓慢,但经过足够的疗程依然能达到令人满意的效果。它能有效提高骨质量,降低骨质疏松脆性骨折的发生率,副反应少,是治疗骨质疏松症的良好选择。Objective To study the effect of strontium ranelate combined with calcium on bone pain, bone mineral density （BMD） , and risk factors of osteoporotie bone fracture during the treatment for osteoporosis, and to evaluate the efficacy and safety of the treatment. Methods One hundred and twenty-four elderly osteoporosis patients were randomly divided into strontium ranelate plus calcium group （ SR ＋ Ca group, 62 cases） and calcium group （Ca group, 62 cases） to perform open and controlled study. Patients in SR ＋ Ca group received oral strontium ranelate 2g/day and calcium 600g/day. Patients in Ca group received oral calcium 600g/day only. VAS scores of the back pain, BMDs and T scores of the lumbar vertebra I-4, the femoral neck, the Ward＇s triangle, and the distal radius were determined. The incidence of osteoporotic fracture and side effects after drug administration in both groups were also observed. Results The VAS scores were obviously improved in SR ＋ Ca group, and the scores were lower than those in Ca group. But the bone pain was alleviated slowly after the treatment. The BMD values and T scores of the lumbar vertebra 1- 4, the femoral neck, the Ward＇s triangle, and the distal radius increased significantly in SR ＋ Ca group after 6-month and 9-month treatment, compared to those before the treatment, and the effect was obviously better than that of Ca group （P 〈 0.01 ）. The incidence of osteoporotic fragile fractures was significantly higher in Ca group than in SR ＋ Ca group. The adverse events were nausea and vomiting in SR ＋ Ca group, and constipation in Ca group. Conclusion The bone pain relieving effect of strontium ranelate started slowly, but could reach a satisfactory result after time enough use. Strontium ranelate effectively improved bone quality and decreased the rate of fragile fracture, with little side effect. It was a good choice for osteoporosis treatment.

关 键 词：雷奈酸锶 骨质疏松症 骨痛 骨密度 骨折 

分 类 号：R681[医药卫生—骨科学]