唑来膦酸、降钙素对骨生化标志物BAP、N-MID、β-CTX的影响  

Effect of zoledronic acid and calcitonin on bone metabolic biochemical markers,BAP,N-MID,and β-CTX

作　　者：孔西建[1] 吴丹[1] 叶进[1] 廉杰[1] 

机构地区：[1]河南省洛阳正骨医院骨质疏松科,洛阳471002

出　　处：《中国骨质疏松杂志》2013年第1期46-50,共5页Chinese Journal of Osteoporosis

摘　　要：目的通过监测绝经后骨质疏松症患者使用唑来膦酸、降钙素治疗前后骨代谢生化标志物的变化来分析二者对骨代谢的影响。方法回顾性分析绝经后骨质疏松症病例115例,55例使用唑来膦酸(5mg静滴一次),60例使用鲑鱼降钙素(50IU隔日一次肌注,治疗90日),检测每个病例治疗前和开始治疗后4周、8周、12周的BAP、N-MID、β-CTX,并进行统计学分析。结果降钙素组治疗4周后BAP、β-CTX与治疗前相比降低(P<0.05),骨转换率降低;治疗8周、12周后β-CTX仍明显降低(P<0.05),但BAP与治疗前相比变化无统计学意义;唑来膦酸组治疗4周、8周后BAP、N-MID、β-CTX与治疗前相比均明显降低(P<0.05),骨转换率明显降低;治疗后12周后BAP、β-CTX仍明显降低(P<0.05);与降钙素组相比,唑来膦酸组治疗后4周、8周BAP、N-MID、β-CTX降低更明显(P<0.05),骨转换率降低更明显;治疗后12周BAP、β-CTX仍明显降低(P<0.05)。两种药物均具有较好的安全性。结论降钙素组、唑来膦酸组均可有效抑制骨吸收,降低骨转换率;与降钙素相比,唑来膦酸抑制骨吸收的作用更迅速、更稳定,病人低骨转换持续时间更久。Objective To analyze the effect of zoledronic acid or calcitonin on bone metabolism by monitoring the changes of bone metabolic markers before and after the treatment of zoledronie acid or calcitonin in patients with postmenopausal osteoporosis. Methods The data of 115 patients with postmenopausal osteoporosis was analyzed retrospectively. Fifty-five patients were treated with zoledronic acid （5mg intravenous drip once）. Sixty patients were treated with salmon caleitonin （50U intramuscular injection every other day, lasting for 90 days）. BAP, N-MID, and β-CTX was tested before and 4-, 8-, and 12-week after the treatment. All the results were analyzed statistically. Result BAP and β-CTX in patients in calcitonin treatment group after 4-week treatment were lower than those before the treatment （p 〈 0.05 ）. The bone turnover rate decreased. After 8- or 12-week treatment, β-CTX was still significantly lower （p 〈 0. 05） , but BAP had no statistical significance compared with that before the treatment. In zoledronic acid group, BAP, N-MID, and β-CTX of patients after 4- or 8-week treatment were significant lower than those before the treatment （p 〈 0.05） The bone turnover rate decreased significantly. After 12-week treatment, BAP and β-CTX were still significantly lower than those before the treatment （p 〈 0.05）. BAP, N-MID, and β-CTX in zoledronic acid group after 4- or 8-week treatment decreased more significantly than those in calcitonin group （p 〈 0.05）. Bone turnover rate decreased more significantly. BAP and β-CTX in zoledronic acid group after 12-week treatment remained significantly low （p 〈 0.05 ）. Both drugs had good property of safety. Conclusion The treatment of both caleitonin and zoledronic acid can effectively inhibit bone resorption and decrease bone turnover rate. Compared with calcitonin, the effect of zoledronic acid on inhibiting bone resorption is more rapid, more stable, and longer low bone turnover duration.

关 键 词：唑来膦酸 降钙素 绝经后骨质疏松症 骨代谢标志物 骨特异性碱性磷酸酶 人氨基端和 中段骨钙素 血清Ⅰ型胶原C端肽 

分 类 号：R681[医药卫生—骨科学]