唑来膦酸治疗椎体骨质疏松的疗效与铁蓄积的相关性  

Correlations between the effects of aclasta on vertebral osteoporosis and iron accumulation

作　　者：经保生 贾鹏[1] 陆政峰[1] 唐胤尧 徐龙 刘云 孟凡剑 徐又佳[1] J1NG Bao-sheng, JIA Peng, LU Zheng-feng, TANG Yin-Yao, XU Long, LIU Yun, MENG Fan-jian, XU You-jia(Department of Orthopedics, Second Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu, Chin)

机构地区：[1]苏州大学附属第二医院骨科,苏州215000

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2018年第2期126-130,共5页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：国家自然科学基金(81572179);国家自然科学基金预研项目(SDFEYG1602);苏州市"科教兴卫"青年科技项目(KJXW2016012);中国博士科学研究基金(2017M621820)

摘　　要：目的研究唑来膦酸治疗椎体骨质疏松疗效与铁蓄积的相关性。方法本研究前瞻性地收集苏州大学附属第二医院2013年1月至2015年2月接受唑来膦酸治疗骨质疏松患者的资料,完成两年以上随访患者共67例。所有患者均检测骨密度(bone mineral density,BMD)、血清铁蛋白(ferritin,Fer)、骨代谢指标及相关生化指标。按血清Fer水平分为正常组和升高组,用t检验分析血清Fer值正常组(Fer≤150μg/L)和血清Fer升高组(Fer>150μg/L)使用唑来膦酸后椎体BMD提升的差异。用Pearson线性相关分析、多元逐步回归分析及偏相关分析,进一步确定血清Fer和使用唑来膦酸后患者椎体BMD增长之间的相关性。结果血清Fer值正常组使用唑来膦酸后椎体BMD增长明显高于血清铁蛋白升高组(P<0.05)。血清Fer水平与使用唑来膦酸后椎体BMD增长值呈负相关(r=-0.269,P<0.05)。校正混杂因素后,血清Fer水平仍与使用唑来膦酸后椎体BMD增长值呈负相关(r=-0.258,P<0.05)。结论铁蓄积抑制唑来膦酸对骨质疏松患者椎体BMD提高的疗效,该结果为降铁疗法治疗骨质疏松的可行性提供了新的临床循证医学依据。Objective To investigate the correlations between the effects of aclasta on vertebral osteoporosis and iron accumulation. Methods The patients with osteoporosis were prospectively admitted to our study from January 2013 to February 2015, and 67 patients were enrolled in a two-year follow-up eventually. We measured bone mineral density and serum ferritin （Fer） , bone metabolic index, and biochemical index. According to serum Fer levels, the patients were divided into the normal group and the elevated group. The difference of bone mineral density was compared by student t＇ test in the normal group （Fern〈 150 μg/L） and the elevated group （Fer〉150 μg/L）. The correlation between serum Fer and the increase of bone mineral density in patients with aclasta was verified by Pearson linear correlation analysis, multi- ple stepwise regression analysis and partial correlation analysis. Results The lumbar bone mineral density in the normal group was significantly higher than that in the elevated group （P〈0. 05 ）. There was a negative correlation between serum Fer and the lumbar bone mineral density （r=-0. 269, P〈0.05）. Adjusmlent for confounding factors, the level of serum Fer was still negatively correlated with the increase of lumbar bone mineral density treated by aclasta （r=-0. 258, P〈 0. 05 ）. Conclusion Iron accumulation is not beneficial to the improvement of osteoporotic vertebral bone density treated by aclasta. The results will provide a new clinical evidence for iron reduction treatment.

关 键 词：唑来膦酸 血清铁蛋白 铁蓄积 骨质疏松 椎体骨密度 

分 类 号：R681[医药卫生—骨科学]