长效双磷酸盐类药物联合钙剂治疗骨质疏松症的临床疗效  

Clinical effect of long-acting bisphosphonates combined with calcium agent in the treatment of osteoporosis

作　　者：胡帆 凌旻[1] 唐长友[1] HU Fan;LING Min;TANG Changyou(Department of Orthopedics,the Fourth Hospital of Changsha,Changsha 410000,China)

机构地区：[1]湖南省长沙市第四医院骨科,410000

出　　处：《临床合理用药杂志》2022年第30期40-43,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察长效双磷酸盐类药物联合钙剂治疗骨质疏松症的临床疗效。方法 选取2018年1月-2020年1月长沙市第四医院收治的骨质疏松症患者84例,采用随机数字表法分为对照组和观察组,每组42例。对照组患者予以碳酸钙D片治疗,观察组在对照组基础上采用唑来膦酸注射液治疗,2组患者均持续治疗1年。比较2组临床疗效,治疗前及治疗1年后骨密度、骨代谢指标[碱性磷酸酶(ALP)、甲状旁腺素(PTH)、骨特异性碱性磷酸酶(BALP)]、骨转换相关指标[骨钙素(OC)、Ⅰ型胶原交联C-末端肽(CTX-1)]、炎性因子[白介素6(IL-6)、白介素10(IL-10)、肿瘤坏死因子(TNF-α)]水平,不良反应。结果 观察组总有效率为92.86%,高于对照组的73.81%(χ^(2)=5.486,P=0.019)。治疗1年后,2组骨密度高于治疗前,且观察组高于对照组(P<0.01)。治疗1年后,观察组ALP、PTH水平及2组BALP、CTX-1水平低于治疗前,2组OC水平高于治疗前,且观察组ALP、PTH、BALP、CTX-1水平低于对照组,OC水平高于对照组(P<0.05)。治疗1年后,2组IL-6、TNF-α水平低于治疗前,IL-10水平高于治疗前,且观察组优于对照组(P<0.01)。观察组不良反应总发生率为7.14%,与对照组的11.90%比较,差异无统计学意义(χ^(2)=0.138,P=0.710)。结论 长效双磷酸盐类药物联合钙剂治疗骨质疏松症的临床疗效确切,能够较好地提高骨密度,改善骨代谢及骨转换,减轻炎性反应,且安全性较高。Objective To investigate the effect of long-acting bisphosphonates combined with calcium agent in the treatment of osteoporosis.Methods A total of 84 patients with osteoporosis admitted to the Fourth Hospital of Changsha from January 2018 to January 2020 were selected,and they were divided into control group and observation group by random number table method,with 42 cases in each group.The control group was treated with calcium carbonate Dtablets,and the observation group was treated with zoledronic acid injection on the basis of control group,both groups were treated for 1 year.Clinical efficacy,bone density,bone metabolism indexes (ALP,PTH,BALP),bone transformation related indexes (OC,CTX-1),inflammatory factors(IL-6,IL-10,TNF-α) before trearment and 1 year after treatment,incidence of adverse reactions were compared between the two groups.Results The total effective rate of observation group was 92.86%,which was higher than 73.81%of control group(χ^(2)=5.486,P=0.019).1 year after treatment,bone density in the two groups were higher than that before treatment,and that in the observation group was higher than control group(P<0.01).1 year after treatment,levels of ALP,PTH in the observation group and levels of BALP,CTX-1 in the two groups were lower than those before treatment,OC level in the two groups was higher than that before treatment,and levels of ALP,PTH,BALP,CTX-1in the observation group were lower than those in control group,OC level was higher than that in control group(P<0.05).1 year after treatment,levels of IL-6,TNF-α in the two groups were lower than those before treatment,level of IL-10 was higher than that before treatment,and those in the observation group were better than control group(P<0.01).There was no significant difference in the incidence of adverse reactions between observation group(7.14%) and control group(11.90%)(χ^(2)=0.138,P=0.710).Conclusion Long-acting bisphosphonates combined with calcium agent have an exact clinical effect in the treatment of osteoporosis,which can effecti

关 键 词：骨质疏松症 双磷酸盐类药物 骨密度 骨代谢 安全性 

分 类 号：R580[医药卫生—内分泌]