钙剂联合骨化三醇治疗绝经后骨质疏松症对照研究  

A control study of calcium combined with calcitriol in the treatment of postmenopausal osteoporosis

作　　者：敖文[1] 徐在革 白杨[1] Ao Wen;Xu Zaige;Bai Yang(Zhengzhou Seventh People's Hospital,Zhengzhou 450006,Henan,China)

机构地区：[1]郑州市第七人民医院,河南郑州450006

出　　处：《临床心身疾病杂志》2021年第4期27-30,49,共5页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨绝经后骨质疏松症患者骨密度、骨代谢标志物水平及钙剂联合骨化三醇治疗对其的影响。方法对102例绝经后骨质疏松症患者(病例组)和102名健康体检者(健康组)L 1-4骨密度、骨代谢标志物(骨钙素、骨源性碱性磷脂酶、抗酒石酸酸性磷酸酶5b、I型胶原C末端肽)水平进行检测分析。将病例组患者按随机数字表法分为对照组与研究组(各51例),对照组予以钙剂治疗,研究组予以钙剂联合骨化三醇治疗,治疗24周。比较研究组和对照组治疗前后疼痛程度、L 1-4骨密度、骨代谢标志物水平、不良反应。结果病例组L 1-4骨密度显著低于健康组(P<0.01),骨钙素、骨源性碱性磷脂酶、抗酒石酸酸性磷酸酶5b、I型胶原C末端肽水平显著高于健康组(P<0.01)。治疗12周、24周末研究组视觉模拟评分法评分显著低于对照组(P<0.01);治疗24周末研究组L 1-4骨密度显著高于对照组(P<0.01),骨钙素、骨源性碱性磷脂酶、抗酒石酸酸性磷酸酶5b、I型胶原C末端肽水平显著低于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论绝经后骨质疏松症患者体内骨密度、骨代谢标志物水平异常,对其予以钙剂联合骨化三醇治疗后患者骨密度增加,骨代谢标志物水平降低,骨骼疼痛症状缓解,安全性较高。Objective To investigate the levels of bone mineral density and bone metabolism markers in postmenopausal patients with osteoporosis and the effect of calcium combined with calcitriol treatment on it.Methods The levels of L 1-4 bone mineral density,bone metabolic markers[bone gla-protein(BGP),bone-specific alkaline phosphatase(BAP),tartrate resistant acid phosphatase-5b(TRACP-5b),C-terminal telopeptides of type I collagen(CTX)]in 102 postmenopausal osteoporosis patients(case group)and 102 healthy subjects(healthy group)were detected and analyzed.Patients in the case group were divided into a control group and a study group(51 cases in each)according to the random number table method.The control group was treated with calcium,and the study group was treated with calcium combined with calcitriol for 24 weeks.The pain degree,L 1-4 bone mineral density,bone metabolic markers and adverse reactions were compared between the two groups before and after treatment.Results The bone density of L 1-4 of the case group was significantly lower than that of the healthy group(P<0.01),and the levels of BGP,BAP,TRACP-5b and CTX were significantly higher than those of the healthy group(P<0.01).The visual analogue scale scores in the study group were significantly lower than those in the control group at the end of 12 and 24 weeks(P<0.01).The bone mineral density of L 1-4 at the end of 24 weeks of treatment was significantly higher than that of the control group(P<0.01).The levels of BGP,BAP,TRACP-5b and CTX were significantly lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions The bone mineral density and bone metabolism markers are abnormally expressed in patients with PMOP.After combined intervention with calcium and calcitriol,the bone mineral density increased,the level of bone metabolism markers decreased,the symptoms of bone pain relieved,and the safety is high.

关 键 词：骨质疏松 绝经 钙剂 骨化三醇 骨钙素 骨源性碱性磷脂酶 抗酒石酸酸性磷酸酶5B I型胶原C末端肽 

分 类 号：R681[医药卫生—骨科学]