重组人甲状旁腺素(1-34)对绝经后妇女骨质疏松症治疗的有效性及对骨代谢标志物水平的影响  

The effectiveness of recombinant human parathyroid hormone(1-34) on the treatment of postmenopausal osteoporosis and its effect on the levels of biochemical markers of bone metabolism

作　　者：刘海蔚[1] 严励[2] 高勇义[1] 陈开宁[1] 方团育[1] 张华川[3] 陈道雄[1] 全会标[1] 陈赛语[1] 

机构地区：[1]海南省人民医院内分泌科,海南海口570311 [2]中山大学附属二院内分泌科,广东广州510120 [3]海南省人民医院内分泌试验室,海南海口570311

出　　处：《现代预防医学》2014年第8期1490-1493,共4页Modern Preventive Medicine

摘　　要：目的观察重组人甲状旁腺素(1-34)[rhPTH(1-34)]联合凯思立D(碳酸钙D3咀嚼片)对绝经后妇女骨质疏松症(PMOP)的骨密度和骨代谢标志物的影响。方法将57例PMOP患者随机分为试验组和对照组,试验组皮下注射rhPTH(1-34)20μg每日1次治疗,对照组肌肉注射降钙素20 IU每周1次治疗。2组均给予凯思立D1片/日(每片含元素钙500 mg和维生素D3 200 IU),试验时间6个月。测定每组治疗前后腰椎L2~4、股骨颈骨密度、骨代谢物血钙、血磷及骨源性碱性磷酸酶(BALP)、血清Ⅰ型胶原交联C末端肽(CTX)等指标。结果试验组腰椎BMD治疗后较治疗前明显增加,差异有统计学意义(P<0.01);对照组腰椎骨密度治疗前后比较差异无统计学意义(P>0.05),组间比较差异无统计学意义(P>0.05)。而2组股骨颈骨密度的变化治疗前后比较均无统计学差异(P>0.05),组间比较差异无统计学意义。试验组CTX和BALP治疗后均较治疗前明显上升(P<0.01)。而对照组CTX治疗后比治疗前下降(P<0.05),BALP在治疗后较治疗前明显升高(P<0.01)。结论重组人甲状旁腺素(1-34)能明显增加腰椎骨密度,升高骨转换指标,治疗绝经后妇女骨质疏松症安全有效。Objective The study aimed to assess the effect of recombinant human parathyroid ho^3none （1-34） [rhPTH （1-34） ] and Calcichew D （calcium carbonate D3 chewable tablets） on bone density and biomarkers of bone metabolism of women with post- menopausal osteoporosis （PMOP）. Methods 57 PMOP patients were randomly divided into an experimental group and a control group; the experimental group was subcutaneously injected with 20 ~g of rhPTH （1-34） once a day, while the control group was in- tramuscularly injected with 20 IU of calcitonin once a week. Both groups were given 1 tablet of Calcichew D daily （each tablet con- tained 500 mg of elemental calcium and 3200 IU of vitamin D） for 6 consecutive months. L2~ lumbar vertebrae, bone density at the femoral neck, blood calcium, serum phosphorus, bone alkaline phosphatase （BALP）, and Type I serum collagen cross-linked C-ter- minal telopeptide （CTX） of the two groups before and after the treatment were measured. Results BMD of the lumbar vertebrae of the experimental group was significantly increased after the treatment （P〈0.01）; no significant differences in lumbar vertebrae BMD were observed before and after the treatment in the control group （P〉O.05） nor between the two groups （P〉0.05）. Changes in bone density at the femoral neck before and after the treatment were not statistically significant in both groups （P〉O.05） or between the two groups. CTX and BALP of the experimental group showed a significant increase after the treatment （P〈0.01）; in contrast, the control group had a significantly decreased CTX （P〈0.05） and a considerably elevated BALP after the treatment （P〈0.01）. Conclusion Recombi- nant human parathyroid hormone （1-34） can significantly improve bone density at the lumbar vertebrae and increase indicators for bone turnover, suggesting that the use of 1-34 in the treatment of postmenopansal osteoporosis is safe and effective.

关 键 词：重组人甲状旁腺素 降钙素 绝经后骨质疏松症 

分 类 号：R173[医药卫生—妇幼卫生保健]