骨化三醇和平衡训练及肌力锻炼对绝经后骨质疏松女性跌倒风险的作用  

Effects of calcitriol, training on balance and lower extremity muscle strength on fall risk of postmenopausal osteoporotic women

作　　者：林华[1] 朱秀芬[1] 陈新[1] 钱程[1] 范璐[1] 黄淑纾[1] 刘畅畅[1] 

机构地区：[1]南京大学医学院附属鼓楼医院骨病中心,210008

出　　处：《中华健康管理学杂志》2012年第3期162-165,共4页Chinese Journal of Health Management

基　　金：基金项目：江苏省社会发展基金项目（BE2011605）

摘　　要：目的探讨绝经后骨质疏松妇女跌倒风险的干预效果。方法200例绝经后骨质疏松或骨量减少妇女，平衡测试提示跌倒中高风险，随机分成A、B两组进行跌倒风险干预。A组干预内容包括，骨化三醇0．25μg,1次／d；跌倒风险和骨质疏松教育；平衡训练；下肢肌力锻炼。B组，骨化三醇0．25μg／d。所有患者每天均补充元素钙600mg和维生素D125IU。评价指标包括跌倒指数、骨密度、血钙磷及不良反应观察。结果干预3个月后，两组患者跌倒指数较干预前自身比较均明显下降（A组t=2．16，P=0．03；B组t=2．08，P=0．04），组间比较差异未见统计学意义；干预6个月后，两组患者跌倒指数继续下降，A组患者跌倒指数下降明显，与B组比较差异有统计学意义（t=2．07，P=0．04）；干预1年后，A组跌倒指数较B组进一步降低（t=2．66，P=0．01）。结论活性维生素D干预3个月即可有效地降低绝经后骨质疏松及其高危人群的跌倒风险，干预12个月可同时提高腰椎骨密度；联合定期的患者教育、平衡训练和肌力锻炼等健康管理措施，跌倒风险干预的有效性和依从性将进一步提高。Objective To investigate the effects of calcitriol, training on balance and lower extremity muscle strength on fall risk of postmenopausal women with osteoporosis or osteopenia. Methods A total of 200 postmenopausal women with osteoporosis or osteopenia, whose balance test confirmed higher fall risk, were randomly assigned to group A or B. Those of group A received the following intervention ： （ 1 ） 0. 25μg calcitriol, QD ; （ 2 ） general information on fall and osteoporosis ; （ 3 ） balance training; （4） lower extremity muscle strength exercises. Those of group B were only treated with 0. 25 μg calcitriol. All the participants were supplemented with 600 mg/d calcium and 125 IU/d vitamin D. Fall index, bone mineral density, serum levels of calcium and phosphorus, and adverse reactions were record. Results After 3 months＇ intervention, the fall index of both groups was significantly decreased （group A： t =2. 16,P 〈0. 05; group B： t =2.08 ,P 〈0.05）. After 6 months＇ intervention,the fall index of both groups went on decreasing, and significant difference of fall index between 6 month and baseline of group A and between group A and group B at 6 months was found. After 1-year intervention, the fall index of group A was further decreased in comparison with group B （ t = 2. 66, P 〈 0.05 ）. No hypercalcemia occurred during the study period. Conclusion The fall risk of the patients with postmenopausal osteoporosis or osteopenia was reduced after 3 months＇ intervention. Twelve months＇ active vitamin D intervention could either reduce the risk of fall or improve bone mineral density. Patient education, balance training and muscle exercise may be effective intervention to reduce fall risk.

关 键 词：骨质疏松 骨密度 骨化三醇 运动 跌倒风险 教育 

分 类 号：R580[医药卫生—内分泌]