阿仑膦酸钠和唑来膦酸对绝经后骨质疏松症患者骨代谢及细胞生长因子的影响

Effects of alendronate and zoledronic acid on bone metabolism and cell growth factors in postmenopausal osteoporosis

目的 对比绝经后骨质疏松症(postmenopausal osteoporosis, PO)应用阿仑膦酸钠、唑来膦酸对骨代谢及细胞生长因子的影响。方法 选择2019年3月至2020年10月郑州市骨科医院医治的PO患者开展研究,总病例数为46例。根据差异性的临床用药,分成观察组(23例)与对照组(23例)。比较治疗前、治疗2个月后患者的细胞生长因子[胰岛素样生长因子2(IGF-2)、纤维细胞生长因子(FGF-21)、转化生长因子β1(TGF-β1)]、骨代谢[Ⅰ型胶原交联C-末端肽(CTX-1)、血清25-羟维生素D(25-OHD)、骨保护素(OPG),以化学发光法检测患者骨钙素(BGP)]、骨密度与安全性。结果 治疗2个月后,观察组和对照组IGF-2、TGF-β1、25-OHD、OPG、BGP、全髋、股骨颈及腰椎的骨密度均升高,观察组更高,差异有统计学意义(P<0.05);观察组和对照组FGF-21、CTX-1均降低,观察组更低,差异有统计学意义(P<0.05);在不良反应方面,观察组(13.04%)与对照组(8.69%)相比,差异无统计学意义(P>0.05)。结论 阿仑膦酸钠和唑来膦酸均对绝经后骨质疏松症有良好的疗效,但唑来膦酸对骨代谢、骨密度及细胞生长因子的影响更为明显,且具有较好的用药安全性。

Objective To compare the effects of alendronate and zoledronic acid on bone metabolism and cell growth factor in postmenopausal osteoporosis(PO).Methods Patients with PO treated in Zhengzhou Orthopaedic Hospital from March 2019 to October 2020 were selected for the study,with a total number of 46 cases.According to the differential clinical medication,they were divided into experimental group(23 cases)and control group(23 cases).Patients'cell growth factors[insulin-like growth factor 2(IGF-2),fibroblast growth factor(FGF-21),transforming growth factorβ1(TGF-β1)],bone metabolism[type I collagen cross-linked C-terminal peptide(CTX-1),serum 25-hydroxyvitamin D(25-OHD),osteoprotegerin(OPG),before and after 2 months of treatment were compared to chemiluminescence assay for patients'osteocalcin(BGP)],bone mineral density and safety.Results After 2 months of treatment,the BMD of IGF-2,TGF-β1,25-OHD,OPG,BGP,total hip,femoral neck and lumbar spine were higher in both experimental and control groups,and the difference was statistically significant(P<0.05);FGF-21 and CTX-1 were lower in both experimental and control groups,and the difference was statistically significant(P<0.05)in the experimental group In terms of adverse reactions,the difference was not statistically significant(P>0.05)between the experimental group(13.04%)and the control group(8.69%).Conclusion Both alendronate and zoledronic acid have good efficacy in postmenopausal osteoporosis,but zoledronic acid has more significant effects on bone metabolism,bone mineral density and cell growth factors,and has better safety of administration.