依降钙素联合阿法骨化醇治疗老年骨质疏松症的疗效及对患者生活质量和骨相关血清标志物的影响  

Effect of carbocalcitonin combined with alfacalcidol on quality of life and bone related serum markers in elderly patients with osteoporosis

作　　者：朱玲玲 赵静[1] 李庆凤 李伟[1] ZHU Ling-ling;ZHAO Jing;LI Qing-feng(Department of Endocrinology,Suzhou Hospital Affiliated to Anhui Medical University,Suzhou Anhui 234000,China.)

机构地区：[1]安徽医科大学附属宿州医院内分泌科,安徽宿州234000

出　　处：《临床和实验医学杂志》2022年第19期2054-2059,共6页Journal of Clinical and Experimental Medicine

基　　金：安徽省重点研究与开发计划项目(编号:202004J07020026)。

摘　　要：目的评价依降钙素联合阿法骨化醇治疗老年骨质疏松症(OP)的疗效以及对患者生活质量和骨相关血清标志物的影响。方法前瞻性选取2020年1月至2022年3月安徽医科大学附属宿州医院收治的老年OP患者82例,采用随机数字表法按1∶1分为对照组和观察组,各41例,其中对照组予以空腹口服阿法骨化醇治疗,0.5μg/次,1次/d;观察组在对照组基础上肌内注射依降钙素,10 U/次,2次/周,连用4周后改为1次/周,均连续治疗6个月。观察两组的治疗效果、股骨颈、第2~4腰椎的骨密度值、视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)得分以及患者的生活质量;比较两组治疗前后的血清钙、磷、碱性磷酸酶(ALP)、抗酒石酸酸性磷酸酶-5b(TRACP-5b)、胰岛素样生长因子-1(IGF-1)、Ⅰ型前胶原氨基末端前肽(PⅠNP)和β-胶原特殊序列(β-Crosslaps)水平。结果观察组治疗总有效率97.56%,显著高于对照组(80.49%),差异有统计学意义(P<0.05)。治疗后,观察组各部位(包括股骨颈、第2~4腰椎)骨密度值和SF-36量表各维度得分显著高于对照组,差异均有统计学意义(P<0.05)。观察组疼痛VAS评分、ODI得分分别为(3.75±0.98)、(21.23±1.87)分,均显著低于对照组[(2.24±0.73)、(15.56±1.44)分],差异均有统计学意义(P<0.05)。治疗后,观察组血清钙、磷、ALP和IGF-1水平分别为(2.31±0.24)mmol/L、(1.30±0.29)mmol/L、(83.11±23.51)U/L、(149.83±22.04)ng/mL,均显著高于对照组[(2.92±0.32)mmol/L、(1.63±0.32)mmol/L、(96.17±19.20)U/L、(183.71±26.29)ng/mL],而TRACP-5b、PⅠNP和β-Crosslaps水平分别为(4.39±0.44)U/L、(45.56±8.66)ng/mL、(0.74±0.11)ng/mL,均显著低于对照组[(3.54±0.35)U/L、(33.70±8.03)ng/mL、(0.56±0.18)ng/mL],差异均有统计学意义(P<0.05);两组不良反应发生率无明显差异(7.32%vs.12.19%,P>0.05)。结论依降钙素联合阿法骨化醇治疗老年OP疗效肯定,可有效提升骨密度水平,缓解疼痛症状和功�Objective To evaluate the efficacy of carbocalcitonin combined with alfacalcitol in the treatment of senile osteoporosis(OP)and its effect on quality of life and bone related serum markers.Methods Eighty-two elderly patients with OP admitted to Suzhou Hospital Affiliated to Anhui Medical University from January 2020 to March 2022 were prospectively selected.According to the random number table method,they were divided into the control group and the observation group according to 1∶1,with 41 cases in each group.The control group was given fasting oral alfacalcidol,0.5μg/time,once/d;The observation group received intramuscular injection of calcitonin on the basis of the control group,10 U/time,2 times/week,after 4 weeks,it was changed to once/week,and the treatment was continued for 6 months.The therapeutic effect,bone mineral density(BMD)of femoral neck,2nd to 4th lumbar vertebrae,visual analogue scale(VAS)score,Oswestry Disability Index(ODI)score,quality of life of the two groups were compared;the content of serum calcium,phosphorus and the activities of alkaline phosphatase(ALP)and tartrate-resistant acid phosphatase-5b(TRACP-5b),insulin-like growth factor-1(IGF-1),typeⅠprocollagen amino terminal propeptide(PⅠNP)andβ-collagen special sequence(β-Crosslaps)were detected.Results The total effective rate of the observation group was 97.56%,which was significantly higher than 80.49%of the control group,the difference was statistically significant(P<0.05).After treatment,the BMD values of all parts(including femoral neck and 2nd~4th lumbar spine)and the scores of SF-36 in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).The pain VAS and ODI scores were(3.75±0.98),(21.23±1.87)points in the observation group,which were significantly lower than those in the control group[(2.24±0.73),(15.56±1.44)points],the differences were statistically significant(P<0.05).After treatment,the contents of serum calcium,phosphorus,ALP and IGF

关 键 词：老年骨质疏松症 依降钙素 阿法骨化醇 疗效观察 生活质量 骨相关血清标志物 

分 类 号：R580[医药卫生—内分泌]