福善美对绝经后妇女骨密度的影响

Effect of fosamax on bone mineral density in postmenopausal women

目的 评价福善美 (Fosamax)治疗绝经后骨质疏松症妇女的近期及中期疗效 ,以及改善骨量作用。方法 绝经 1年以上女性 80名 ,分成 4组 ,A组 :14例 ,年龄 5 4 . 97± 5. 5 1(47～ 6 2 )岁 ,绝经年限≤10年 ,疗程 6个月～ 1年 ;B组 :2 3例 ,年龄 5 5 . 5 5± 3. 6 6 (5 0～ 6 2岁 ) ,绝经年限≤ 10年 ,疗程 1年以上 ;C组 :18例 ,年龄 6 8. 18± 5 . 5 9(5 9～ 78岁 ) ,绝经年限 >10年 ,疗程 6个月～ 1年 ;D组 :2 5例 ,年龄6 7. 2 5± 6 .19(5 2～ 80岁 ,绝经年限 >10年 ,疗程 1年以上。患者每天接受口服福善美 10mg和元素钙5 0 0mg,疗程 6个月～ 2 8年。治疗前、后应用双能X线吸收仪 (HologicQDR 2 0 0 0型 )进行骨密度(BMD)测定。结果 4组不论绝经年限长短 ,通过 6个月～ 2年以上福善美治疗 ,腰椎BMD平均增加百分率 3 74 %～ 5 4 5 % ,较基础值均有明显增加 (P <0 . 0 0 1) ,4组间差异无统计学意义 (P >0 . 0 5 )。股骨颈部位治疗后BMD平均增加百分率为 0 84 %～ 4 2 1% ,其中绝经年限相同时 ,疗程长者高于短者 ,即B组高于A组 ,D组高于C组 ;疗程相同时 ,绝经年限长者高于短者 ,即C组高于A组 ,D组高于B组 ,但 4组间差异无显著性 (P >0 . 0 5 )。大转子部位治疗后BMD增加平均变化百分率 1 4. 2

Objective To evaluate the short-and long-term effects of Fosamax on bone mineral density in postmenopausal women with primary osteoporosis. Methods Eighty women with menopause duration more than one year were divided into 4 groups. Group A: 14 cases, mean age 54.97±5. 51(47-62) years, menopause duration≤10 years, after 6 months to 1 year's therapy. Group B: 23 cases, mean age 55.55±3.66 (50-62) years,menopause duration≤10 years, after more than 1 year's therapy; Group C: menopause duration>10 years, after 6 months to 1 year's therapy. Group D: 25 cases, mean age 67.25±6.19 (52-80) years, menopause duration>10 years, after more than 1 year's therapy. All patients were treated with oral Fosamax 10 mg/day and supplementation of elementary calcium 500 mg/day. The treament period lasted from 6 months to 2.8 years. BMD were evaluated by the dual energy x-ray absorptiometry (Hologic QDR 2000) before and after the therapy.Results After 6 months to 2.8 years' Fosamax therapy, in all of the four groups, lumbar BMD increased 3.74%-5.45% on an average, significamly higher(P<0.001) than baseline no matter how long the menopause duration. But the differences between four groups showed no statistical sigrificamce(P>0.05). The femoral neck BMD increased 0.84%-4.21% on an averape after therapy, and increased more the with longer treatment course than in the group with shorter freatment course when they had the same duration of menopause, it means that BMD increased more in Group B than in Group A, and morein Group D than in Group C. in the increased more longer menopause group with than in the group shorter menapause, therapy. BM it means BMD increased more that in Group C than in Groups A and more in Group D than in group B. But there were no significan differences between the 4 groups (P>0.05). After fosamax therapy, BMD at greater frochenters in the four groups increased 1.42%-4.69% on an average ; increased 3.11% in Group A (P<0.001), 2.24% in Group B (P<0.01), 1.42% in Group C(P>0.05), and 4.69% in Group D(P<0.001). In comparison, there was no difference between Group A and Group B (P>0.05).BMD in Group A increased more than in Group C (P<0.05). The rates of increase in BMD were higher in Group D than in Group B (P<0.01). and higher in Group D than in Group C ((P<0.01).) Conclusions Fosamax significantly improves BMD of lumbar shines. To increcsse the cortical bone BMD, it needs longer to samax therapy. In treating BMD at femoral neck , Fosamax does better in women with longer menopause duration and it is good for lowering the incidences of femoral neck fracture in old persons.