静脉补钙治疗骨质疏松症的疗效和安全性  

Clinical efficacy and safety of intravenous calcium for osteoporosis

作　　者：叶盛开 陈海英 任霞 温洁 杜颖 苗新颖 李雪 张茹 于莉 张碧莹 王冰冰 YE Sheng-kai;CHEN Hai-ying;REN Xia;WEN Jie;DU Ying;MIAO Xin-ying;LI Xue;ZHANG Ru;YU Li;ZHANG Bi-ying;WANG Bing-bing(Department of Endocrinology,the 967th Hospital of PLA,Liaoning Dalian 116021,China)

机构地区：[1]解放军第967医院内分泌科

出　　处：《临床药物治疗杂志》2019年第10期46-51,共6页Clinical Medication Journal

摘　　要：目的:探讨静脉补钙治疗骨质疏松症(osteoporosis,OP)的疗效和安全性。方法:选取963例OP患者,分为对照组、口服补钙组、静脉补钙组和联合补钙组。补钙疗程均超过2年。对比4组患者的一般资料、骨密度(bone mineral density,BMD)、疼痛、运动功能、相关生化指标、骨质疏松指标、颈动脉内膜中层厚度(intima-media thickness,IMT)的改变情况、关节置换手术率、脱牙率以及骨折、心脑血管病、腰椎间盘突出症(lumbar disc herniation,LDH)、感染、恶性肿瘤的发病率。结果:4组患者基线水平无显著性差异(P>0.05)。补钙治疗后,4组患者间的肝肾功异常、胆结石及肾结石、冠心病、心衰、心血管钙化、高钙血症及恶性肿瘤的发病率及IMT无显著性差异(P>0.05)。与对照组相比,口服补钙组的腰椎和髋部BMD均明显升高(P<0.05),碱性磷酸酶(alkaline phosphatase,ALP)、视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)、骨折发病率均显著下降(P<0.05),而关节置换手术率、脱牙率以及心律失常(早搏、心动过速、心房颤动)、LDH、感染及脑梗死的发病率在2组间无显著性差异(P>0.05);与对照组和口服补钙组相比,接受静脉补钙治疗的2组患者的腰椎和髋部BMD均明显升高(P<0.01),而ALP、VAS、ODI、骨折发病率、关节置换手术率、脱牙率以及心律失常、LDH、感染及脑梗死的发病率均显著下降(P <0.01);静脉补钙组与联合补钙组的上述指标均无显著性差异(P>0.05)。结论:长期口服钙剂或者静脉补钙均是治疗骨质疏松症的有效方法,其中静脉补钙的疗效更好。Objective:To analyze the clinical efficacy and safety of intravenous calcium for osteoporosis(OP).Methods:A total of 963 OP patients were divided into control group,oral calcium group,intravenous calcium group and combination calcium group.Calcium treatments lasted for more than 2 years.Medical record was collected to compare demographic data,changes in bone mineral density(BMD),improvements of pain and function,changes of biochemical parameters,OP parameters and intima-media thickness(IMT),fractures,rate of total arthroplasty and tooth loss,incidence of cardiovascular and cerebrovascular diseases,incidence of lumbar disc herniation(LDH),infection and tumors.Results:There was no group difference at baseline(P>0.05).In the four groups,the incidence of liver and kidney abnormalities,gallstones and kidney stones,coronary heart disease(CHD),heart failure,cardiovascular calcification,hypercalcemia and tumors,and IMT had no statistically significant difference after2 years of calcium treatment(P> 0.05).Compared to the control group,the BMDs of the lumbar vertebrae and hip in the oral calcium group were significantly increased(P <0.05),alkaline phosphatase(ALP),visual analogue scale(VAS),Oswestry disability index(ODI),and incidence of fractures in the oral calcium group were significantly decreased(P<0.05).There were no statistically significant differences between the rate of total arthroplasty and tooth loss,incidence of arrhythmia(premature beats,tachycardia,atrial fibrillation),LDH,infection and cerebral infarction of the control group and oral calcium group(P>0.05).Compared to the control group and the oral calcium group,the BMDs of the lumbar vertebrae and hip in the intravenous calcium group and combination anti-osteoporosis group were significantly increased(P <0.01),ALP,VAS,ODI,incidences of fractures,rate of total arthroplasty and tooth loss,incidence of arrhythmia,LDH,infection and cerebral infarction in the intravenous calcium group and combination anti-osteoporosis group were significantly decreased(P<0.01)

关 键 词：静脉补钙 口服补钙 骨质疏松症 

分 类 号：R977.5[医药卫生—药品]