牛奶与钙剂对老年人骨密度作用的8年临床观察

Eight years clinical observation on effect of taking calcium combined with milk on the elderly BMD

目的观察牛奶与钙剂对老年人骨密度作用。方法采用日本东芝公司制造的Xpress-GX螺旋CT（QCT）,对本院老年职工进行第3腰椎骨密度（L3BMD）检测。选择L3BMD降低的82名（男性35,女性47）老年人,根据本人意愿（是否饮用牛奶和服用钙剂）分成观察组（n=43）和对照组（n=39）,观察组（男性18,女性25）,每人每日饮鲜牛奶250 ml～500 ml并日服含维生素D的钙剂（元素钙600～1200 mg、维生素D3125～300 IU）;对照组（男性17,女性22）未饮牛奶、未服钙剂,两组连续观察96个月为终点。在治疗前后分4个时间段（0、6、30、96个月）应用QCT检测参组老人L3BMD值,同时进行肝、肾功能、血清钙、尿钙及肝、胆、肾B超检查,并同步座谈访问,了解治疗后反应。结果①两组老人L3BMD均随增龄逐渐降低,其中,男女性观察组在长期钙奶干预下,自身配对比较L3BMD值,虽然逐次降低,但幅度很小;而男女性对照组的L3BMD逐年降低幅度明显增大,但无统计学意义（P〉0.05）。②两组间（观察组与对照组）分4个时间段成组比较L3BMD值,前3个时间段,对照组比观察组降低,但无明显差异（P〉0.05）,观察至第4个时间段（96个月）时,男女性对照组L3BMD比观察组明显降低,差异有显著性（P〈0.05）。结论老年人长期饮用牛奶与含维生素D钙剂,能有效地延缓中轴骨BMD降低;长期钙奶干预对骨量增加能起到累积效应;对BMD降低而引起临床症状的老年人起到了重要辅助治疗作用;长时间应用钙剂未发现与之相关疾病发生。

Objective To explore the effect on BMD of the elderly by taking calcium eombined with milk. Methods After examining L3 BMD of retired employee of the Affiliated Hospital of Chengde Medical College with QCT, we selected L3BMD lower 82 persons （male 35, female 47） from them as participants, they were divided into treatment group （n = 43, male 18, female 25） and control group （n = 39, male 17, female 22） based on their will, participants in treatment group took 250 - 500 ml fresh milk and calcium （600 mg-1200 mg） including vitamin D3 （ 125 IU - 300 IU） every day, participant in control group didn＇t take neither of milk and calcium, the observation lasted 96 months. During the process of observation, L3 BMD of participants were examined at the 0^th month, the 6^th month, the 30^th month, 96^th month. The other examinations including liver function, kidney function, blood serum calcium and urine calcium were taken. And liver, gallbladder, kidney were examined through B mode ultrasound at the same time. In addition, we visited participants to know their idea about treatment. Results （1） Cmnparing with oneself, the L3 BMD of all participants was getting lower and lower along with age, the control group lowered even more than the treatment group. （2） Comparing L3 BMD of control group with L3 BMD of cure group, from the first stage to the third stage, i.e. the 0^th month, the 64 month and the 30^th month in the process of observation, L3 BMD of control group was lower than cure group, but had no statistical significance （ P 〉 0.05）, at the fourth stage, i.e. the 96th month, L3 BMD of control group was more lower than cure group, and showed statistical significance （ P 〈 0.05 ）. Conclusions Long-term taking calcium including vitamin D combined with milk delayed dropping of BMD for the elderly, presented accumulating effect, and acted as assistant cure means for elder osteoporosis patient. We had no discovered disease concerned with Long-term taking calcium occur.