摘要
目的探讨5 mg唑来膦酸注射液联合钙和维生素D对女性绝经后骨质疏松症的临床疗效和安全性。方法选择51例应用唑来膦酸的绝经后骨质疏松患者为研究对象，所有患者均接受5 mg唑来膦酸静脉注射治疗1次，骨化三醇0.25 μg/d及碳酸钙600 mg/d作为基础用药，口服1年。比较治疗前和治疗后1年血钙、血磷、骨代谢标志物和腰椎、髋部骨密度的变化，观察药物不良反应情况。结果治疗后1年，女性绝经后骨质疏松症患者腰椎（第1腰椎、第2腰椎、第3腰椎、第4腰椎、第1-4腰椎）骨密度和髋部（颈部、转子、内部、总和）骨密度、25-羟维生素D较用药前升高（P〈0.05），骨转换标志物β-胶原特殊序列、总Ⅰ型胶原氨基端延长肽、血清碱性磷酸酶、骨钙素水平较治疗前下降（P〈0.05），治疗前后血钙、血磷、甲状旁腺素（PTH）水平比较差异未见统计学意义（P〉0.05）；不良反应发生率为19.6%。结论5 mg唑来膦酸联合钙和维生素D可降低绝经后骨质疏松症女性的骨转换指标，增加腰椎及髋部骨密度，减少骨量流失和骨折风险，且不良反应发生率低，安全性较好。
Objective To investigate the efficacy and security of 5 mg zoledronic acid injection combined with calcium and vitamin D on postmenopausal osteoporosis.Methods Fifty-one postmenopausal osteoporosis patients who used zoledronic acid were collected as subjects. All patients were treated with intravenous infusion of 5 mg zoledronic acid for once, and orally took Calcitriol 0.25 μg/d and calcium carbonate 600 mg/d as basic medicine for one year. The difference in levels of calcium, phosphorus, bone metabolism markers, mineral density of lumbar vertebra and hip bone before treatment and 1 year after treatment were observed and compared; incidence of adverse reactions was observed.Results After one-year of treatment, the bone mineral densities of lumbar vertebra （the first, second, third, and forth lumbar vertebra, first to forth vertebra） and hip bone （neck of femur, trochanter of femur, internal femoral, total）, levels of 25 hydroxyvitamin D increased significantly, compared with those before medication （P〈0.05）; bone turnover marker such as β-crosslaps total procollagen typeⅠ amino-terminal propeptide, alkaline phosphatase and osteocalcin decreased significantly （P〈0.05）; there was no significant difference in levels of serum calcium, phosphorus before treatment and after 1 year of treatment （P〉0.05）. The incidence of adverse reactions was 19.6%.Conclusions 5 mg zoledronic acid combined with calcium and vitamin D can reduce the levels of bone turnover markers of postmenopausal osteoporosis, increase bone mineral density of lumbar vertebra and hip bone, decrease loss of bone mass, and has low incidence of adverse reactions and high safety.
作者
夏雪迪
许莉军
王志芳
李珊
李冲
郑丽丽
Xia Xuedi, Xu Lijun, Wang Zhijang, Li Shan, Li Chong, Zheng Lili(Department of Endocrinology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Chin)
出处
《中国实用医刊》
2018年第5期95-99,共5页
Chinese Journal of Practical Medicine
关键词
唑来膦酸
绝经后骨质疏松症
骨转换标志物
骨密度
Zoledronic acid
Postmenopausal osteoporosis
Bone turnover maker
Bone mineral density
