3种方案治疗绝经后骨质疏松疗效观察  

Effects of three regimens in the treatment of osteoporosis in postmenopausal women

作　　者：李轶琳[1] 高双[1] 郑庆红[1] 李景丽[1] 金鲜英[1] 崔满华[1,2] 

机构地区：[1]大庆油田总医院,黑龙江大庆163001 [2]吉林大学附属二院妇产科

出　　处：《中国妇幼保健》2011年第20期3157-3159,共3页Maternal and Child Health Care of China

基　　金：黑龙江省卫生厅科技计划立项项目〔2010-384〕

摘　　要：目的：探讨3种不同方案治疗绝经后妇女骨质疏松的临床疗效。方法：将绝经后伴骨量减少妇女110例,随机分成3组。A组36例,钙尔奇D 1 200 mg/d＋骨化三醇0.25μg/bid;B组39例,钙尔奇D 1 200 mg/d＋骨化三醇0.25μg/bid＋替勃龙1.25 mg/d;C组35例,钙尔奇D 1200 mg/d＋骨化三醇0.25μg/bid＋盐酸雷洛昔芬60 mg/d。3组妇女连续治疗1年。治疗前后测定腰椎第1~4节（L1~4）及股骨骨密度（BMD）;同时检测血清骨碱性磷酸酶（BALP）及血清Ⅰ型前胶原肽（CTX）评价骨代谢指标。结果：①骨痛症状改善。3组妇女治疗1年后骨痛症状均得到改善,A、B、C组改善率分别为83%、92%、95%。②骨密度升高。3组妇女治疗后骨密度明显升高,分别与治疗前比较,差异均有统计学意义（P〈0.05）;治疗后1年B、C组妇女BMD均较A组显著升高,差异有统计学意义（P〈0.01）,但B、C两组间比较,差异无统计学意义（P〉0.05）。③骨代谢指标。3组妇女治疗后BALP及CTX水平均较治疗前降低,差异有统计学意义（P〈0.05）;3组间比较,治疗1年后血清CTX水平,B组较C组显著下降,差异有统计学意义（P〈0.01）,B组较A组下降更为显著,差异有统计学意义（P〈0.000 1）。结论：3种方案均可用于骨质疏松的治疗,降低骨转换、增加BMD、减少骨吸收。Objective：To evaluate clinical efficacy of three regimens in the treatment of osteoporosis of postmenopausal women.Methods：110 postmenopausal women with low bone mineral density（BMD） or osteoporosis treated in our hospital were divided into three groups.36 women in group A managed by caltrate D600 1 200 mg/d ＋ calcijex 0.25 μg/bid orally;39 women in group B managed by caltrate D600 1 200 mg/d＋ calcijex 0.25 μg /bid ＋ tibolone 1.25 mg/d orally;35 women in group C managed by caltrate D 600 1 200 mg/d ＋ calcijex 0.25 μg /bid ＋ raloxifene 60mg/d orally.After 1 year BMD on lumbar 1-4（L1-4） and femur were detected by X-ray.Bone alkaline phosphatase（BALP） and type I collagen C-telopeptides were measured as biochemical markers of bone metabolism.Results：①Pain relieve： after 1 year treatment,women in three groups improved symptom of pain significantly,the rates of pain relieve were 83% in group A,92% in group B,95% in group C.②BMD： It was shown significantly different between group B or C and group A（P0.05）,however,there was no significant different between group B and C after 1 year treatment（P0.05）.③Index of bone metabolism： BALP were showed statistical different after 1 year treatment in three groups（P0.05）.CTX was shown significantly different between group B or C and group A（P0.01）,moreover,there was significantly different between group B and A after 1 year treatment（P0.0001）.Conclusion：Those 3 regimens combination can be used in treatment of osteoporosis by decreasing bone conversion,increasing bone density,decreasing bone absorption.

关 键 词：替勃龙 盐酸雷洛昔芬 骨化三醇 绝经 骨密度 骨质疏松 

分 类 号：R711.75[医药卫生—妇产科学]