伊班膦酸钠与阿仑膦酸钠对绝经后骨质疏松疗效的比较

The comparison of the clinical effects between ibandronate and alendronate in treatment of postmenopausal osteoporosis

目的:评价伊班膦酸钠与阿仑膦酸钠对绝经后骨质疏松的疗效。方法:绝经后骨质疏松妇女32例,随机分为2组,所有患者每天在接受元素钙500mg和维生素D200IU治疗的同时,分别接受伊班膦酸钠和阿仑膦酸钠治疗,其中伊班膦酸钠150mg每月1次;阿仑膦酸钠70mg每周1次。2种药物治疗时间均为1年。通过双能X线吸收仪(DEXA)及血清I型胶原交联C端肽(CTX-1)观察治疗中及治疗后的骨量及骨转换的变化。结果:2组患者经过1年治疗,与用药前比较,腰椎(L2-4)骨量显著上升(P<0.05),髋部骨量增加但没有统计学意义(P>0.05):其中伊班瞵酸钠治疗组腰椎L2-4、股骨颈、股骨大转子和全髋骨密度分别上升15.34%、4.15%、5.05%和2.49%;阿仑瞵酸钠治疗组分别上升14.50%、4.42%、1.18%和2.64%;破骨指标血清CTX-1在2组均明显下降(P<0.05)。2组之间各时点的各部位骨密度值、血清CTX-1值均无统计学差异(P>0.05)。结论:伊班膦酸钠服用方便,且对于绝经后骨质疏松的治疗效果与阿仑膦酸钠无明显差异。

Objective：To evaluate the clinical efficacy of ibandronate and alendronate in postmenopausal osteoporotic women. Methods：A total of 32 postmenopausal women with osteoporosis were randomly classified into two groups, 16 in each： group A,oral ibandronate 150 mg per month;and group B,oral alendronate 70 mg per week. All patients received calcium 500 mg and Vitamin D 200 IU daily for one year. All patients were examined by DEXA （lumbar,hip）before and after treatment. At the same time the biochemical marker of bone resorption serum C-terminal telopeptide-Ⅰ（CTX-1）was determined. Results：The BMD of lumbar spine （L2-4） significantly increased compared with that of pretreatment in both groups （P 〈 0.05）,the BMD of hip locations also increased but without significance. The increases of BMD in ibandronate group were 15.34%,4.15%, 5.05%, 2.49% at L2-4,femoral neck, trochanter and the total of hip respectively,those in alendronate group were 14.50% ,4.42% ,1.18% ,2.64% respectively; serum CTX-1 levels decreased dramatically in both groups （P 〈 0.05）. The BMD change rates in all locations and the CTX-1 decreases at all time points between the two groups were not significant. Conclusion：Ihandronate is more convenient for long-term use than alendronate, which is as effective as alendronate for increasing bone mineral density and for inhibiting osteoclastic activity in treatment of postmenopausal osteoporosis.