帕米膦酸二钠对绝经后妇女骨质疏松症骨密度及骨转换标记物的影响

Effect of Pamidronate Disodium on Bone Mineral Density and Bone Conversion Markers in Female with Postmenopausal Osteoporosis

目的:探讨帕米膦酸二钠对绝经后妇女骨质疏松症的临床疗效。方法:将85例绝经后骨质疏松患者随机分为2组,治疗组给予帕米膦酸二钠、钙剂及活性维生素D;对照组仅给予钙剂和活性维生素D。分别于治疗后6、12个月观察2组患者骨痛改善情况、骨密度(BMD)、骨转换标记物等水平的变化。结果:治疗组治疗6、12个月后骨痛VAS评分、各部位BMD水平、骨转换标记物以及血清护骨素(OPG)、细胞核因子-κB受体活化因子配体(RANKL)水平均较治疗前显著改善(P<0.05或P<0.01),对照组治疗12个月后骨痛VAS评分、骨转换标记物以及OPG、RANKL水平均较治疗前显著改善(P<0.05或P<0.01),且治疗组改善程度显著优于对照组(P<0.01)。治疗组发生恶心2例,肝功能轻度异常1例,对照组治疗期间未发现明显不良反应。结论:帕米膦酸二钠治疗绝经后骨质疏松症可有效激活成骨细胞功能,促进骨形成,抑制骨吸收,提高骨密度,从而显著改善骨痛症状,且不良反应轻微,具有良好的临床应用前景。

Objective To explore the clinical effect of pamidronate disodium(PD) in patients with postmenopausal osteoporosis.Methods Eighty-five patients with postmenopausal osteoporosis were randomly divided into two groups and given calcium and activated vitamin D,patients in treatment group were given PD in addition.The relief of bone pain,changes of bone mineral density(BMD) and bone conversion markers in two groups were observed at 6,12,24 months after treatment.Results The VAS score of bone pain,levels of BMD,bone conversion markers,OPG and RANKL in treatment group were obviously improved and better than those of control group after treated for 6 and 12 months(P<0.05 or P<0.01).There were two cases of nausea and one case of mild dysfunction of liver in treatment group,while there was no obvious adverse reaction in control group.Conclusion PD can activate the osteoblast function,promote osteogenesis,inhibit bone absorption so as to improve BMD and relieve bone pain in treatment of postmenopausal osteoporosis.PD could be effectively used.