摘要
目的 探讨早期应用阿仑膦酸钠对中老年红斑狼疮（lupus erythematosus,LE）患者糖皮质激素性骨质疏松症（glucocorticoid induced osteoporosis,GIOP）防治的影响。方法 回顾性分析2013年2月—2014年2月82例行糖皮质激素（GC）维持剂量治疗的55岁以上LE患者临床资料,根据是否早期应用阿仑膦酸钠将其分为观察组44例和对照组38例。分析两组患者治疗过程中GIOP发生率及不良反应发生情况,记录GC用药前（T0）、GC用药6个月后（T1）、GC用药1年后（T2）骨特异性碱性磷酸酶（BAP）、抗酒石酸酸性磷酸酶（TRAP-5b）等骨代谢生化指标及全髋关节、腰椎L2~4节段骨密度（BMD）水平差异。结果 T2时观察组GIOP发生率显著低于对照组（P〈0.05）。对照组在T1和T2时血清BAP、TRAP-5b水平较T0时显著升高（P〈0.05）;T1和T2时观察组上述指标均显著低于对照组（P〈0.05）。对照组在T1和T2时全髋关节及腰椎L2~4节段BMD水平较T0时显著降低（P〈0.05）;T1和T2时观察组上述指标均显著高于对照组（P〈0.05）。两组不良反应发生率比较差异无统计学意义（P〉0.05）。结论 GC治疗初期应用阿仑膦酸钠口服疗法,能有效降低中老年LE患者GIOP发生风险。
Objective To investigate effects of early application of Alendronate Sodium in prevention and treatment of glucocorticoid induced osteoporosis（ GIOP） in middle-elderly patients with lupus erythematosus（ LE）. Methods Clinical data of 82 LE patients over 55 year-old with maintenance dose of glucocorticoid（ GC） treatment during February 2013 and February 2014 was retrospectively analyzed,and the patients were divided into observation group（ n = 44）and control group（ n = 38） according to whether or not early application of Alendronate Sodium. In two groups,the incidence rates of GIOP and adverse reactions during treatment were analyzed; the differences in bone of metabolic biochemical indexes such as bone alkaline phosphatase（ BAP） and tartrate-resistant acid phosphatase（ TRAP-5b）,bone mineral density（ BMD） levels of total hip joint and lumbar vertebrae L2-4segments before application of GC（ T0）,6 months of GC（ T1） and 1 year of GC（ T2） were recorded. Results At T2,the incidence rate of GIOP in observation group was significantly lower than that in control group（ P〈0. 05）. In control group,serum BAP and TRAP-5b levels at T1 and T2 were significantly higher than those at T0（ P〈0. 05）; the above indexes at T1 and T2 in observation group were significantly lower than those in control group（ P〈0. 05）. In the control group,BMD levels of the total hip joint and lumbar L2-4segments at T1 and T2 were significantly lower than those at T0（ P〈0. 05）; the above indexes at T1 and T2,in observation group were significantly higher than those in control group（ P〈0. 05）. There was no significant difference in incidence rate of adverse reactions between the two groups（ P〉0. 05）. Conclusion The application of oral Alendronate Sodium in early stage of GC treatment can effectively reduce the risk of GIOP in middle-elderly patients with LE.
出处
《解放军医药杂志》
CAS
2016年第12期83-86,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
关键词
阿仑膦酸钠
糖皮质激素类
骨质疏松
红斑狼疮
治疗
Alendronate sodium
Glucocorticoids
Osteoporosis
Lupus erythematosus
Therapy
