联合应用阿仑膦酸钠及阿法骨化醇对围绝经期及绝经后妇女骨质疏松症的影响  

The Effects of Combination Therapy of Alendronate and Alfacalcidol on Osteoporosis in Patients with Perimenopause or Menopsuse

作　　者：管玉涛[1] 张琼[1] 蔡莲莲[1] 赵宇[1] 吕杰强[1] 丁红香[2] 陈国丹[3] 

机构地区：[1]温州医学院附属第二医院妇产科,325027 [2]温州医学院附属第二医院检验科,325027 [3]温州医学院附属第二医院放射科,325027

出　　处：《医学研究杂志》2011年第7期108-110,170,共4页Journal of Medical Research

摘　　要：目的评价联合应用阿仑膦酸钠及阿法骨化醇对围绝经期及绝经后妇女骨质疏松症的影响。方法征集2008年7月～2009年12月妇科更年期门诊骨量减少或骨质疏松症的围绝经期及绝经后患者56例，随机分为两组，实验组：口服阿仑磷酸钠70mg每周1次＋阿法骨化醇胶囊0．25μg每日2次＋复方氨基酸鳌合钙1000mg每日1次；对照组：口服复方氨基酸鳌合钙1000mg每日1次。两组均连续服药48周。治疗前、后采用双能x线吸收法测定腰椎1～4节（L1-4）及左股骨密度（BMD）；同时抽血清检测骨代谢指标：骨碱性磷酸酶（BALP）、I型胶原C端肽（CTX）、25（OH）D3。结果两组在治疗48周后临床疼痛等症状均明显改善与好转，有效率分别为93．55％和64．00％，有显著差异（P〈0．05）；试验组L1-4及左股骨部位骨密度均较治疗前显著提高（P〈0．05），两者增幅为（2．87±2．75）％和（2．53±1．14）％。治疗后两组之间比较，两者差异有显著性（P〈0．05）。试验组能有效降低BALP及CTX、升高25（OH）D，水平，三者改变率分别为（-19．56±17．67）％、（-6．12±3．94）％和（＋6．34±3．17）％，与治疗前相比，差异均有显著性（P〈0．05）；治疗后两组相比，三者改变率差异均有显著性（P〈0．05）。结论联合应用阿仑膦酸钠及阿法骨化醇在治疗围绝经期及绝经后妇女骨质疏松症效果良好。Objective To evaluate the effects of combination therapy of Alendronate and Alfacalcidol on osteoporosis for perimenopause or menopause. Methods 56 women who were perimenopause or menopause with low bone mineral density or osteoporosis were applied from July 2008 to December 2009 for 48 weeks. They were divided into 2 groups randomly： experimental group （ taking bisphosphonates 70mg/w ＋ alfacalcidol 0. 25μg/bid ＋ Osteoform 1000mg/d oral） and control group （taking the Osteoform 1000mg/d oraly）. BMD on lmnbar 1 - 4 and left femur as well as biochemical markers of bone turnover such as BALP, CTX and 25 （ OH ） D3 were measured before and alter treatment. Results Patients in two groups were good for improving the pain significantly,and the ratio of efficiency was 93.55% and 64.00%. There was significant difference between two groups （ P 〈 0.05 ）. Changes of BDM of lumbar 1 - 4 and left femur were （ 2.87 ± 2.75 ） % and （2.53 ± 1.14） % respectively in experimental group, and the difference between before and after treatment was statistically distinct（ P 〈 0.05 ）. There was significant difference in therapeutic effects after treatment between two groups. The decreasing amplitude of BALP and the CTX,and increasing amplitnde of 25 （OH）D3 was （3.33 ± 1.21 ）% , （4.87 ± 2.52）% , （6. 12 ± 3.94）% respectively. The change ratio of them was （ -19.56±17.67）% ,（ -6.12±3.94）% and（ ＋6.34±3.17）% respectively,and tor all of them, the difference between before and after treatment was statistically dinstinct（ P 〈 0.05 ）. There was significant difference in therapeutic effects after treatment anong them. Conclusion The combination of Alendronate and Alfaealeidol was effective in treating osteoporosis for perimenopause or menopsuse.

关 键 词：围绝经期及绝经后 骨质疏松症 骨密度 骨代谢指标 联合治疗 

分 类 号：R277.525[医药卫生—中医学]