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阿伦膦酸钠防治原发性骨质疏松症的疗效观察 |
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夏维波 孟迅吾 胡莹莹 刘怀成 秦明伟 余卫 邢小平 田均平 周学瀛
【摘 要】目的 观察阿伦膦酸钠对妇女原发性骨质疏松症的有效性和安全性。方法 25例原发性骨质疏松症妇女每日口服阿伦膦酸钠10mg和元素钙500mg(碳酸钙)疗程12月。通过双能X线吸收仪(DEXA)、定量CT(QCT)、胫骨超声速率(SOS)及生化指标观察治疗中及治疗后的骨量及骨转换的变化。结果 DEXA骨密度L2～4于治疗3个月、6个月和12个月时均较治疗前有显著升高(P<0.01)，升高率分别为3.3%、4.4%和7.2%。股骨近端骨密度也有升高；经QCT检查的腰椎(L1～4)骨密度于治疗12个月时显著增加(8.1%，P<0.01)；胫骨超声速率于治疗的6个月、9个月和12个月时较治疗前分别增加1.4%(P<0.05)、1.8%(P<0.01)和1.4%(P<0.05)。同时治疗中伴有骨转换指标的降低。未发现与药物有关的不良反应。结论 阿伦膦酸钠10mg/d对绝经后妇女骨质疏松症有效和安全。
【关键词】骨质疏松症 骨矿盐密度 阿伦膦酸钠
Effects of the bisphosphonate alendronate on primary osteoporosis
Xia Weibo,Meng Xunwu,Hu Yingying,et al.
(Department of Endocrinology,PUMC Hospital,CAMS and PUMC,Beijing 100730)
【Abstract】Objective To determine the efficiency and safety of alendronate on primary osteoporosis in women.Methods 25 Chinese women aged(66.8±6.4)yrs with primary osteoporosis were enrolled.All subjects received alendronate 10mg and calcium 500mg daily for 12 months.Results Follow-up dual energy X-ray absorptiometry showed that bone mineral density increased progressively in a significant way in lumbar spine(L2～4by 3.3%,4.4% and 7.2%in 3,6 and 12 months respectively)and proximal femur.BMD of L1～4 determined by quantitative computerized tomography also increased significantly in 12 months after treatment(8.1%,P<0.001).The speed of sound on tibia rose by 1.4%(P<0.05),1.8%(P<0.01)and 1.4%(P<0.05)in 6,9 and 12 months respectively after treatment.The marker of bone turnover significantly declined after treatment.There was no adverse experience associated with alendronate during the whole study.Conclusion Alendronate significantly increases BMD and is well tolerated at doses of 10 mg daily in the treatment of primary osteoporosis in women.
【Key words】Osteoporosis Bone mineral density Alendronate
阿伦膦酸钠(alendronate)是新一代的二膦酸盐，具有强力抑制骨吸收、降低骨转移、预防骨量丢失、增加骨量和降低骨折发生率的作用，治疗剂量不引起矿化障碍［1～3］。本研究旨在观察阿伦膦酸钠对妇女绝经后骨质疏松症防治的有效性和安全性。
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