唑来膦酸注射液对2型糖尿病合并骨质疏松患者骨密度的影响及治疗机制研究  

Effect of zoledronic acid injection on bone mineral density in type 2 diabetes patients with osteoporosis and its therapeutic mechanism

作　　者：王顺阁 田伟华 WANG Shunge;TIAN Weihua(Department of Endocrinology,Pingdingshan the Second People's Hospital,Pingdingshan,Henan 467000,China;Department of Critical Care Medicine,Pingdingshan the Second People's Hospital,Pingdingshan,Henan 467000,China)

机构地区：[1]平顶山市第二人民医院内分泌科,河南平顶山467000 [2]平顶山市第二人民医院重症医学科,河南平顶山467000

出　　处：《中国医学工程》2023年第8期83-87,共5页China Medical Engineering

基　　金：河南医学科技攻关项目(2021001673)。

摘　　要：目的观察唑来膦酸注射液对改善2型糖尿病(T2DM)合并骨质疏松患者骨密度的影响,分析其药理机制。方法回顾性分析平顶山市第二人民医院2020年5月至2022年2月收治的131例T2DM合并骨质疏松患者为研究对象,采用抽签法,将入组患者分别列为试验组(66例)和对照组(65例),对照组仅予以常规治疗,试验组采用唑来膦酸注射液配合治疗,比较两组患者的血糖水平、不同区域骨密度水平、骨代谢水平,对所有患者开展为期6个月的短期随访,评估其用药安全性。结果治疗前,两组患者的血糖、骨密度、骨代谢水平差异均无统计学意义(P>0.05);治疗后,试验组的空腹血糖(FBG)、餐后2 h血糖(2 h FBG)、糖化血红蛋白(HbA1c)水平与对照组比较差异无统计学意义(P>0.05);试验组的Ward三角区、股骨、腰椎骨密度水平高于对照组,骨保护素(OPG)高于对照组,骨特异性碱性磷酸酶(BALP)高于对照组,1型胶原C端β特殊序列(β-CTX)水平低于对照组(P<0.05);随访期间,试验组的药物相关副反应发生率[9.09%(6/66)]略高于对照组[7.69%(5/65)],但差异无统计学意义(P>0.05)。结论采用唑来膦酸注射液辅助治疗T2DM合并骨质疏松可在不影响患者的血糖水平基础上,促进其骨密度水平提升及骨代谢情况改善,且联合应用此药未明显增加患者药物副反应发生风险,安全性较高,其药理机制主要体现在对破骨细胞、骨吸收的抑制方面。【Objective】To observe the effect of zoledronic acid injection on the improvement of bone mineral density in patients with type 2 diabetes mellitus(T2DM)and osteoporosis,and analyze its pharmacological mechanism.【Methods】A total of 131 T2DM patients with osteoporosis admitted to our hospital from May 2020 to February 2022 were taken as the research object.The enrolled patients were divided into the test group(66 cases)and the control group(65 cases)by the method of drawing lots.The control group was only given routine treatment.The test group was treated with zoledronic acid injection solution,and the blood glucose level,bone mineral density level in different regions,and bone metabolism level of the two groups were compared.All patients were followed up for 6 months to evaluate their drug safety.【Results】Before treatment,the blood glucose,bone mineral density and bone metabolism of the two groups were similar(P>0.05).After treatment,the levels of fasting blood glucose(FBG),2h FBG and hemoglobin A1c(HbA1c)in the test group were similar to those in the control group(P>0.05).The bone mineral density levels of Ward's triangle,femur and lumbar vertebrae in the test group were higher than those in the control group,and osteoprotegerin(OPG)and bone-specific alkaline phosphatase(BALP)were higher than those in the control group,the level ofβ-C TX was lower than that of the control group(P<0.05).During the follow-up period,the incidence of drug-related side effects in the test group was 9.09%(6/66),which was slightly higher than that in the control group[7.69%(5/65)](P>0.05).【Conclusion】Zoledronic acid injection as an adjunctive treatment for T 2 DM with osteoporosis can promote the increase of bone mineral density and bone metabolism without affecting the blood glucose level of patients.The combined use of this drug does not significantly increase the risk of side effects of drugs in patients with high safety.Its pharmacological mechanism is reflected in the inhibition of osteoclasts and bone resorption.

关 键 词：2型糖尿病 骨质疏松 唑来膦酸注射液 骨密度水平 用药安全性 

分 类 号：R587.1[医药卫生—内分泌]