密骨片对绝经后骨质疏松症骨密度、血清骨保护蛋白及其配体水平和骨代谢指标的影响

Effects of Migu Tablet on Bone Mineral Density, Serum Levels of Osteoprotegerin and Its Ligand and Bone Metabolic Markers in Patients with Postmenopausal Osteoporosis

目的观察密骨片治疗绝经后骨质疏松症患者骨密度(BMD)、血清骨保护蛋白(OPG)和骨保护蛋白配体(OPGL)水平及骨代谢指标的变化。方法将年龄48～65岁的192名自然绝经的妇女进行骨密度测定,对其中160例骨质疏松妇女进行随机分组,其中密骨片组54例,仙灵骨葆组53例,乐力钙组53例;其余BMD正常32例作为对照组。各组均于用药前、后12、24周,采用酶联免疫吸附试验(ELISA)测定血清OPG与OPGL水平、骨碱性磷酸酶(sBAP)、骨钙素(sOC)、Ⅰ型胶原交联C端肽(sCTx)和尿Ⅰ型胶原交联N端肽(uNTx),用双能X线吸收法(DEXA)测定腰椎正位、股骨颈、Ward’s三角和大粗隆的BMD。结果治疗24周后,密骨片组和仙灵骨葆组BMD均有不同程度的提高,OPGL、sBAP、sOC均有明显升高,而OPG、sCTx、uNTx/Cr明显下降,乐力钙组和对照组变化不明显。结论密骨片治疗绝经后骨质疏松症疗效较显著,与仙灵骨葆相仿。单纯服用钙剂不能治疗绝经后骨质疏松症,且继续骨流失。

Objective To study the effects of Migu Tablet （MGT） on bone mineral density （BMD）, serum levels of osteoprotegerin （OPG） and its ligand （OPGL）, and bone metabolic markers in patients with postmenopausal osteoporosis （PMO）. Methods BMD in 192 women of natural menopause, 48 to 65 years old, were determined. Among them, 160 women with PMO were randomized into 4 groups, 54 in the Migu Tablet group （MGTG）, 53 in the Xianlin Gubao group （XLGBG） and 53 in the Leli Calcium group （LCG）. And the other 32 women with BMD in normal range were set as the control group. Serum levels of OPG, OPGL, bone alkaline phosphates （sBAP）, osteocalcin （sOC）, cross-linked C-telopeptides of collagen type Ⅰ （sCTx）, and urine level of bone cross-linked N-telopeptides of collagen type Ⅰ （uNTx） were measured before treatment and at the 12th and 24th week of treatment, with enzyme-linked immunosorbent assay （ELISA） ; BMD of orthophoric lumbar vertebrae, femoral neck, Ward＇s triangle and trochanter were determined by dual-energy X-ray absorptiometry at the same time as well. Results After 24-week treatment, BMD was heightened to different degree, serum levels of OPG, sCTx, uNTx/Cr were significantly decreased and OPGL, sBAP, sOC were increased in the MGTG and XLGBG, while these indexes showed insignificant change in the LCG and the control group. Conclusion The effect of MGT in treating PMO were notable, just like that of XLGB, but single medication of calcium tablet cannot alleviate the disease and also incapable to prevent the loss of bone.