阿仑膦酸钠对绝经后骨质疏松症患者生活质量的影响  

Effect of alendronate treatment on quality of life in postmenopausal women with osteoporosis

作　　者：周沛然[1] 洪霞[2] 夏维波[1] 邢小平[1] 韩兰稳[1] 姜艳[1] 王鸥[1] 徐苓[3] 李梅[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院内分泌科,卫生部内分泌重点实验室,北京100730 [2]中国医学科学院北京协和医学院北京协和医院心理科,北京100730 [3]中国医学科学院北京协和医学院北京协和医院妇产科,北京100730

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2013年第3期207-212,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：国家十一五科技攻关课题(2006BAI02B03);国家自然科学基金面上项目(81100623)

摘　　要：目的评价不同剂量阿仑膦酸钠对绝经后骨质疏松或骨量减少女性患者短期生活质量的影响。方法 100例平均年龄(65.06±6.86)岁的绝经后骨量减少或骨质疏松女性纳入本研究,随机分为阿仑膦酸钠标准剂量(70 mg/周)组或低剂量(70 mg/2周)组,均治疗1年。治疗前后采用SF-36量表进行生活质量测评,包括生理功能(PF)、生理职能(RP)、身体疼痛(BP)、总体健康(GH)、活力(VT)、社会功能(SF)、情感职能(RE)、精神健康(MH)8个维度及1项健康变化(HT)指标。用双能X线骨吸收仪测量腰椎和股骨近端骨密度(BMD)。分别用自动分析仪和化学发光法测量骨转换生化指标碱性磷酸酶(ALP)及Ⅰ型胶原羧基端肽交联(β-CTX)水平。用化学发光法测量治疗前25羟维生素D(25OHD)水平。结果共92例患者完成随访。治疗1年时,2组患者血清ALP、β-CTX水平均较治疗前显著降低(P<0.05),各部位BMD显著升高(P<0.05);标准剂量组血清β-CTX水平降低程度较低剂量组更为明显(P<0.05),2组间其他指标治疗前后差异无统计学意义。标准剂量组PF(P=0.006)、RP(P=0.002)、BP(P=0.049)、VT(P=0.006)、RE(P=0.012)5个维度评分显著高于治疗前;低剂量组PF(P=0.015)、GH(P=0.000)、SF(P=0.041)3个维度评分较治疗前明显提高。结论采用阿仑膦酸钠70 mg/周或70 mg/2周治疗不仅能显著降低绝经后骨质疏松或骨量减少女性患者血清骨吸收指标水平、增加腰椎和股骨近端骨密度,而且能明显改善生活质量。Objective To evaluate the effect of different doses of alendronate （ALN） on quality of life in post- menopausal women with osteoporosis or osteopenia. Methods 100 postmenopausal women aged 65.06 ±6. 86 y with osteopenia or osteoporosis received randomly standard-dose ALN （70 mg weekly） or low-dose ALN （70 mg every two weeks） for 12 months. The quality of life was evaluated by SF-36, including eight sections of physical functioning （PF）, role-physical （ RP）, bodily pain （ BP）, general health （ GH）, vitality （ VT）, social functioning （ SF）, role-emotional （RE）, mental health （MH）. Bone mineral density （BMD） was measured by dual-energy x-ray absorptiometry and serum carboxy-telopeptide of type I collagen （13-CTX） and total alkaline phosphatase （ALP） levels were assessed by ehemilumi nescence immunoassay and automatic analyser, respectively. Results 92 women completed the treatment. BMD was ob- viously increased and serum bone turnover markers levels were significantly decreased in the two dosage groups after the treatment （P 〈 0.05）. No differences in percentage changes were found in BMD and ALP levels between the two dosage groups, except in percentage changes of CTX （P 〈 0. 05 ）. The scores of PF （ P = 0. 006） , RP （ P = 0. 002） , BP （ P = 0. 033）, VT （P = 0. 006） and RE （P = 0. 011 ） were increased significantly after the treatment of standard-dose ALN. The scores of PF （P =0. 015） , GH （P =0. 000） and SF （P =0. 041 ） were increased significantly after the treatment of low-dose ALN. Conclusion Treatment with ALN of 70 mg/w or 70 mg/2w could not only effectively reduce serum bone turnover markers levels, increase BMD at lumbar spine and proximal femur in postmenopausal women with osteopenia or osteoporosis, but also could improve the quality of life of the patients.

关 键 词：阿仑膦酸钠 骨质疏松症 生活质量 骨密度 

分 类 号：R681[医药卫生—骨科学]