特立帕肽联合阿仑膦酸钠对绝经后骨质疏松症患者骨密度、骨代谢和生活质量的影响  

Effects of Teriparatide Combined with Alendronate Sodium on Bone Density, Bone Metabolism and Quality of Life of Postmenopausal Patients with Osteoporosis

作　　者：刘玉章[1] 李耀华[1] 段永刚[1] 潘东续 韩梅[2] 周志玲[1] LIU Yu-zhang;LI Yao-hua;DUAN Yong-gang;PAN Dong-xu;HAN Mei;ZHOU Zhi-ling(Department of Orthopedics,the Second Hospital Affiliated to Hebei North University,Zhangjiakou,Hebei 075100,China;Operating Room,the Second Hospital Affiliated to Hebei North University,Zhangjiakou,Hebei 075100,China)

机构地区：[1]河北北方学院附属第二医院骨外科,河北张家口075100 [2]河北北方学院附属第二医院手术室,河北张家口075100

出　　处：《临床误诊误治》2021年第9期35-39,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省2019年度医学科学研究课题计划项目(20190034);张家口市重点研发计划项目(1921020D)。

摘　　要：目的探讨特立帕肽联合阿仑膦酸钠对绝经后骨质疏松症患者骨密度、骨代谢和生活质量的影响。方法选取2019年2月—2020年4月收治的绝经后骨质疏松症78例,根据治疗方法不同将其分为观察组(41例)和对照组(37例)两组。观察组采用特立帕肽联合阿仑膦酸钠治疗,对照组采用阿仑膦酸钠治疗。观察比较两组治疗前和治疗后6个月骨密度、骨代谢指标、骨痛情况和生活质量,以及治疗期间不良反应。结果治疗前,两组骨密度、骨代谢指标、骨痛情况和生活质量比较差异均无统计学意义(P>0.05)。治疗后6个月,两组腰椎、股骨颈、全髋骨密度及骨钙素(OCN)、简明健康状况调查表(SF-36)评分均较治疗前升高,抗酒石酸酸性磷酸酶-5b(TRAP-5b)、Ⅰ型胶原交联羧基末端肽(CTX-Ⅰ)和骨痛视觉模拟评分法(VAS)评分均较治疗前降低;观察组腰椎、股骨颈、全髋骨密度及OCN、SF-36评分均高于对照组,TRAP-5b、CTX-Ⅰ和骨痛VAS评分均低于对照组,差异有统计学意义(P<0.05或P<0.01)。治疗期间,两组总不良反应发生率比较差异无统计学意义(P>0.05)。结论特立帕肽联合阿仑膦酸钠治疗绝经后骨质疏松症患者可提高骨密度,改善骨代谢异常,缓解骨痛,提升生活质量,且安全性良好。Objective To investigate effects of Teriparatide combined with Alendronate Sodium on bone density,bone metabolism and quality of life of postmenopausal patients with osteoporosis.Methods Seventy-eight patients with postmenopausal osteoporosis admitted between February 2019 and April 2020 were selected and divided into observation group(n=41)and control group(n=37)according to different therapeutic methods.Observation group was treated with Teriparatide combined with Alendronate Sodium,while control group was treated with Alendronate Sodium.Conditions of bone density,bone metabolism indexes,bone pain and quality of life before and after treatment for 6 months,as well as incidence rates of adverse reactions during treatment were observed and compared between two groups.Results Before treatment,there were no significant differences in values of bone density,bone metabolism indexes,bone pain and quality of life between two groups(P>0.05).After treatment for 6 months,bone density values of lumbar vertebrae,femoral neck and total hip bone,as well as osteocalcin(OCN)and scores of Short-Form 36 Health Survey Questionnaire(SF-36)were significantly higher,while values of tartrate-resistant acid phosphatase-5b(TRAP-5b)and type I collagen cross-linked carboxy-terminal peptide(CTX-Ⅰ)and scores of bone pain visual analogue scale(VAS)were significantly lower than those before treatment in two groups;in observation group,bone density values of lumbar vertebrae,femoral neck and total hip bone as well as OCN level,and the SF-36 score were significantly higher,while values of TRAP-5b,CTX-I and bone pain VAS score were significantly lower than those in control group(P<0.05 or P<0.01).There was no significant difference in total incidence rate of adverse reactions between two groups(P>0.05).Conclusion Teriparatide combined with Alendronate Sodium in treatment of postmenopausal patients with osteoporosis may improve bone density and abnormal bone metabolism,relieve bone pain and improve quality of life with good safety.

关 键 词：骨质疏松 绝经后 特立帕肽 阿仑膦酸钠 骨密度 骨钙素 抗酒石酸酸性磷酸酶-5b Ⅰ型胶原交联羧基末端肽 生活质量 

分 类 号：R681[医药卫生—骨科学]