胰岛素联合阿仑膦酸钠对老年糖尿病骨质疏松症患者骨密度及血清BAP、TRAP-5b、BGP水平影响  

Effect of insulin combined alendronate sodium on bone mineral density and levels of serum BAP、TRAP-5b and BGP in aged patients with type 2 diabetes mellitus with osteoporosis

作　　者：王芳[1] 任汉强[1] 沈晓波[1] 

机构地区：[1]江汉大学附属医院内分泌科,湖北武汉430015

出　　处：《海南医学院学报》2016年第13期1387-1389,1393,共4页Journal of Hainan Medical University

基　　金：湖北省自然科学基金项目(2013CDB145)~~

摘　　要：目的：探究胰岛素联合阿仑膦酸钠对老年糖尿病骨质疏松症患者骨密度及血清骨特异性碱性磷酸酶（BAP）、人抗酒石酸酸性磷酸酶5b（TRAP-5b）、骨钙素（BGP）水平的影响。方法：选取2014年1月~2016年1月我院收治的糖尿病骨质疏松症患者136例,随机分成4组,各34例。所有患者等时等量服用钙尔奇D作基础药使用,对照组采用胰岛素治疗,二甲双胍组采用二甲双胍治疗,联合组采用二甲双胍联合阿仑膦酸钠治疗,实验组采用胰岛素联合阿仑膦酸钠治疗,检测各组治疗前及治疗1年后股骨颈骨密度（BMP）及血清BAP、TRAP-5b、BGP水平,并比较各组治疗前后数据差异。结果：骨密度指标：治疗后,对照组及二甲双胍组无显著差异（P〉0.05）;联合组略有改善,但与治疗前及其他组治疗后相比无统计学意义（P〉0.05）,实验组治疗后骨密度提升较为明显（P〈0.05）。骨转换指标：对照组、联合组及实验组血清BAP和BGP指标均较治疗前提升,TRAP-5b指标均较治疗前降低,但只有实验组差异显著（P〈0.05）;实验组骨转换指标均显著优于其他各组,差异具有统计学意义（P〈0.05）。结论：胰岛素联合阿仑膦酸钠治疗糖尿病骨质疏松症患者能有效平衡骨代谢,疗效显著,安全可靠,值得推广应用。Objective：To explore effect of insulin combined alendronate sodium on bone mineral density and levels of serum BAP,TRAP-5band BGP in aged patients with type 2diabetes mellitus with osteoporosis.Methods：A total of 136 patients with type 2diabetes mellitus with osteoporosis in January 2014 to January 2016 in our hospital were selected for the treatment,and were randomly divided into 4groups,with 40 cases of each group.Caltrate D was given as a basic treatment to all the patients,and the control group was given the treatment of insulin,and the metformin group was given the treatment of Metformin,and the combination group was given the treatment of metformin combined alendronate,and the experiment group was given the treatment of insulin combined alendronate.BMD of the femoral neck and the serum levels of BAP,TRAP-5band BGP were detected and recorded before the treatment and 1year after the treatment,and the results were analyzed.Results：On index of bone mineral density,the control group and the metformin group has no significant differences（P〉0.05）;the combination group has a slightly improved,but has no significant differences（P〉0.05）;after the treatment,the bone mineral density of the experiment has significantly improved（P〈0.05）.On index of bone turnover,the levels of serum BAP and BGP all have improved and the level of TRAP-5ball have reduced then before the treatment in the control group,the combination group and the experiment group,but only the experiment group has significant differences（P〈0.05）;On index of bone turnover,the experiment group are better then other groups,the differences have statistical significance（P〈0.05）.Conclusions：It has great clinical curative effect that insulin combined alendronate sodium in the treatment of aged patients with type 2diabetes mellitus with osteoporosis,it can effectively balance the metabolism of bone,safe and reliable,and it is worthy of application.

关 键 词：糖尿病骨质疏松症 胰岛素 阿仑膦酸钠 骨特异性碱性磷酸酶(BAP) 

分 类 号：R587.1[医药卫生—内分泌]