二膦酸盐类药物治疗妇女绝经后骨质疏松症的疗效观察  

Clinical efficacy of bisphosphonates in the treatment of postmenopausal osteoporosis

作　　者：王莉[1] 胡玮[1] 白人骁[1] 孔德诚[1] 

机构地区：[1]天津医院骨科研究所,300211

出　　处：《中华骨科杂志》2001年第9期526-528,共3页Chinese Journal of Orthopaedics

摘　　要：目的观察国产羟乙磷酸二钠和阿仑膦酸钠治疗女性绝经后骨质疏松症的疗效。方法83例女性绝经后骨质疏松症患者,随机分成三组Ⅰ组(37例)口服羟乙磷酸二钠(400mg/d)、Ⅱ组(15例)口服阿仑膦酸钠(10mg/d)和Ⅲ组(31例)服用安慰剂。Ⅰ组及Ⅲ组均采用间歇循环疗法即每疗程前两周服药停药11周后重复,3个月为一个疗程,共三个疗程9个月;Ⅱ组连续用药,总疗程为9个月。各组均每天同时服用钙剂片(相当于元素钙500mg)。治疗前后分别应用美国Hologic公司的QDR4500W型双能X线骨密度仪测定骨密度(BMD)并且化验血、尿常规,肝、肾功能及血钙、磷、碱性磷酸酶、尿钙/肌酐比值。结果Ⅰ、Ⅱ组治疗前后BMD有非常显著性变化P<0.01,而Ⅲ组无变化P>0.05。Ⅰ组总有效率为78.4%,Ⅱ组为80.0%,Ⅲ组为48.4%。Ⅰ组和Ⅱ组BMD的增长显效率相比,差异有非常显著性意义P<0.01。生化指标尿钙/肌酐比值治疗前后差异有显著性意义P<0.05。结论国产羟乙磷酸二钠和阿仑膦酸钠能使骨质疏松症患者骨量增加,且价格便宜,是适合我国国情的治疗骨质疏松症的药物。临床上可选用简单可靠的尿钙/肌酐比值作为观察骨代谢变化的指标。Objective To evaluate the clinical efficacy of domestic bisphosphonates (etidronate and alendronate) in the treatment of postmenopausal osteoporosis. Methods Eighty three patients with postmenopausal osteoporosis were divided randomly into three groups: group Ⅰ(37 cases),group Ⅱ(15 cases) and group Ⅲ(31 cases). Etidronate(400 mg/d) and placebo were given with intermittent cyclical therapy in group Ⅰ and group Ⅲ respectively, and alendronate(10 mg/d) was given continuously in groupⅡ for 9 months. Eeach group was given calcium agents(equal to elementary calcium 500 mg/d). Before and after treatment, the bone mineral density(BMD) was measured by dual energy X ray absorptiometry. The biochemical markers such as blood calcium, phosphate, alkaline phosphatase and urine calcium/creatinin were examined. Results After treatment the BMD of groupⅠ and groupⅡ wee increased obviously(P< 0.01) and no change in group Ⅲ(P >0.05). The BMD of group Ⅱ was increased more than that of groupⅠ(P< 0.01). The total effective rates were 78.4% in groupⅠ, 80.0%in groupⅡ, and 48.4%in control group respectively. The urine calcium/creatinin was decreased in groupⅠ and group Ⅱ as compared with groupⅢ. Conclusion The domestic bisphosphonates can increase the BMD of the patients with postmenopausal osteoporosis and is of a cheap price. So it is a kind of good anti osteoporotic drugs conforming to the situation in our country. The urine calcium/creatinin is an economical and practical marker to observe the bone metabolic changes.

关 键 词：骨质疏松 绝经后 羟乙磷酸二钠 骨密度 药物治疗 

分 类 号：R58[医药卫生—内分泌]