锝[^(99)Tc]亚甲基二膦酸盐联合钙剂、维生素D_3治疗原发性骨质疏松症(I型)骨转换标志物变化的临床观察  

Clinical Observation of 99 Technetium Methylenediphosphonate Combined with Calcium and Vitamin D_3 in the Treatment of the Change of Bone Metabolism Markers Caused by Primary Osteoporosis(Type Ⅰ)

作　　者：郑飞波[1] 王明民[1] 柳炳吉[1] 朱文茹[1] 梁杰[1] 于华[1] 

机构地区：[1]青岛大学医学院第二附属医院核医学科,山东青岛266042

出　　处：《中国药房》2013年第4期345-346,共2页China Pharmacy

摘　　要：目的:观察锝[99Tc]亚甲基二膦酸盐与钙剂、维生素D3联合治疗原发性骨质疏松症骨转换标志物的变化。方法:选择60例原发性骨质疏松症(Ⅰ型)患者,随机均分为对照组和治疗组。对照组给予维生素D31μg/d和钙尔奇-D片600mg/d,服用150d;治疗组在对照组的基础上给予锝[99Tc]亚甲基二膦酸盐22mg/d缓慢静脉滴注,10d为1个疗程,间隔15d开始下一疗程,共6个疗程。治疗前和开始治疗第3、5个月分别测定2组患者骨转换标志物[尿脱氧吡啶啉交联蛋白(Dpd)和Ⅰ型胶原N端肽(NTX)、血骨特异性碱性磷酸酶(BALP)和骨钙素(BGP)]水平并进行比较,观察2组患者不良反应发生率。结果:治疗组治疗后骨转换标志物水平均较对照组显著降低,差异有统计学意义(P<0.05),而且尿Dpd和NTX、血BALP和BGP变化率均显著高于对照组,差异有统计学意义(P<0.05)。2组均未见不良反应发生。结论:锝[99Tc]亚甲基二膦酸盐与钙剂、维生素D3联合治疗原发性骨质疏松症可以有效降低骨转换率,增加骨量,从而改善原发性骨质疏松症患者的生活质量,且安全性较好。OBJECTIVE：To observe the change of bone metabolism markers caused by primary osteoporosis treated with 99 technetium methylenediphosphonate combined with calcium and vitamin D3.METHODS：60 patients suffered from primary osteoporosis（type Ⅰ）were randomized into treatment group and control group with 30 cases in each group.Control group were treated with vitamin D3（1 μg/d）and Caltrate with vitamin D tablets（600 mg/d）for 150 days.Based on the therapeutic regimen of control group,treatment group were treated with 99 technetium methylenediphosphonate 22 mg/d intravenous drip for 10 days,subsequently with an intermission for 15 days,repeated 6 cycles.The markers of bone metabolism（urine Dpd and NTX,BALP and BGP） were detected and compared separately in different period of pre-therapy,3 months or 5 months after treatment.The incidence of adverse drug reactions were observed in 2 groups.RESULTS：The levels of markers in treatment group decreased obviously after treatment,compared with in corresponding control group;there was statistical significance（P0.05）.The change of urine Dpd,NTX,BALP and BGP in treatment group surpassed obviously in control group;there was statistical significance（P0.05）.No adverse drug reaction was found in 2 groups.CONCLUSION：The combination therapy of 99 technetium methylenediphosphonate,calcium and vitamin D3 is effective and safe in lowering the rate of bone turnover,increasing bone quality and improving life quality of patients with primary osteoporosis.

关 键 词：锝[99Tc]亚甲基二膦酸盐 钙剂 维生素D3 原发性骨质疏松症 骨转换标志物 

分 类 号：R681[医药卫生—骨科学]