依替膦酸二钠联合阿仑膦酸钠维D3对骨质疏松患者骨密度及血清甲状旁腺激素、骨钙素水平的影响  

Influence of etidronate disodium combined with alendronate sodium and vitamin D3 on bone mineral density, levels of parathyroid hormone and osteocalcin in patients with osteoporosis

作　　者：李晶 王斌 Li Jing;Wang Bin(Department of Endocrinology,Xidian Group Hospital,Xi’an 710000,China;Department of Orthopedics,Xidian Group Hospital,Xi’an 710000,China)

机构地区：[1]西电集团医院内分泌科,西安710000 [2]西电集团医院骨科,西安710000

出　　处：《中国实用医刊》2024年第10期86-89,共4页Chinese Journal of Practical Medicine

基　　金：西安市科技计划项目(XA2020-YXYJ-0321)。

摘　　要：目的探讨依替膦酸二钠联合阿仑膦酸钠维D3对骨质疏松患者骨密度及血清甲状旁腺激素(PTH)、骨钙素(OC)水平的影响。方法回顾性抽取2019年1月至2023年3月西电集团医院收治的老年骨质疏松患者82例, 按照治疗方案分为对照组和联合组, 每组41例。对照组采用阿仑膦酸钠维D3治疗, 联合组采用依替膦酸二钠联合阿仑膦酸钠维D3治疗。比较两组临床疗效, 比较两组治疗前后视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)、骨密度、血清相关因子[PTH、OC、抗酒石酸酸性磷酸酶-5b(TRACP-5b)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)]水平, 比较两组不良反应发生率。结果联合组总有效率(95.12%, 39/41)高于对照组(80.49%, 33/41),P<0.05。治疗3、6个月后, 联合组VAS评分、ODI低于对照组, 腰椎骨密度、髋部骨密度、股骨颈骨密度高于对照组, 血清PTH、OC、TRACP-5b、β-CTX水平低于对照组(P<0.05)。联合组不良反应总发生率(12.20%, 5/41)与对照组(4.88%, 2/41)比较差异未见统计学意义(P>0.05)。结论依替膦酸二钠联合阿仑膦酸钠维D3治疗骨质疏松, 可提高骨密度, 缓解骨痛, 调节血清PTH、OC水平。Objective To investigate the influence of etidronate disodium combined with alendronate sodium and vitamin D3 on bone mineral density and the levels of parathyroid hormone(PTH)and osteocalcin(OC)in osteoporosis patients.Methods A total of 82 elderly patients with osteoporosis admitted to Xidian Group Hospital from January 2019 to March 2023 were retrospectively selected.And they were divided into a control group and a combination group according to treatment plan,with 41 cases in each group.The control group was treated with alendronate sodium and vitamin D3,and the combination group was treated with etidronate disodium combined with alendronate sodium and vitamin D3.The clinical efficacy of the two groups were compared.And the levels of visual analogue scale(VAS)score,Oswestry dysfunction index(ODI),bone mineral density,serum related factors,including PTH,OC,artrate-resistant acid phosphatase-5b(TRACP-5b),β-isomer of C-terminal telopeptides of type I collagen(β-CTX)before and after treatment were compared between the two groups.The incidence of adverse reactions were compared between the two groups.Results The total effective rate of the combination group(95.12%,39/41)was higher than that of the control group(80.49%,33/41),P<0.05.After 3 and 6 months of treatment,the scores of VAS and ODI in the combination group were lower than those in the control group,the bone mineral density of the lumbar spine,hip and femoral neck of the combination group were higher than those of the control group,and the serum levels of PTH,OC,TRACP-5b andβ-CTX were lower than those of the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the combination group(12.20%,5/41)and the control group(4.88%,2/41),P>0.05.Conclusions Etidronate disodium combined with alendronate sodium and vitamin D3 in the treatment of osteoporosis can improve bone mineral density,alleviate bone pain,and regulate the levels of serum PTH and OC.

关 键 词：骨质疏松 依替膦酸二钠 阿仑膦酸钠维D3 骨密度 骨钙素 

分 类 号：R580[医药卫生—内分泌]