阿仑膦酸钠对甲亢并骨质疏松患者的疗效分析

Effects of alondronate on bone mineral density in hyperthyroid osteoporosis

目的观察阿仑膦酸钠对青壮年（20—40岁）甲亢患者骨密度（BMD）的影响。方法选择正常健康志愿者30例作为正常对照组（B组），腰椎骨密度低于健康年轻女性减1．0—2．0标准差的青壮年（20—40岁）甲亢患者共76例，随机分为2组，抗甲亢药治疗组（A1）38例，服抗甲亢药；抗甲亢药加阿仑膦酸钠治疗组（A2）38例，在服抗甲亢药基础上加服阿仑膦酸钠5mg／d。两组共服药12个月。结果抗甲亢药加阿仑膦酸钠治疗组A2组腰椎、股骨颈及大粗隆的骨密度均明显升高（P〈0．05），其中腰椎骨密度治疗前为（0．91±0．09）g／cm2，治疗后12个月达到（1．11±0．07）异／cm2，增加率为30．6％，明显高于A1组（P〈0．05）。12个月治疗总有效率A2组为61．2％，显著高于A1组的31．6％（P〈0．05）。患者无严重副作用。结论阿仑膦酸钠能明显提高甲亢患者的骨密度．副作用轻。

Objective To study the efficacy of Alondronate on bone mineral density （BMD） in hyperthyroid osteopo- rosis. Methods 76 cases of hyperthyroid osteoporosis were randomly divided into two groups, A2 groups （38 cases） treated with alondronate and tapazol, A1 group （38 cases） treated with tapazol, and both groups treated for twelve months. All patients were followed up at 0 and 12th months. Results Bone mineral density （BMD） of lumbar vertebra, femoral neck, and greater trochanter increased significantly in A2 group than that in A1 group （ P 〈 0.05 ） BMD of lumbar vertebar was （0. 91 ± 0. 09） g/ cm2 before treatment （1.11 ± 0. 07 ） g/cm2 and 12 months after treatment, with an increased rate of 30. 6%. Overall effective rate in A2 group was 61.2% 12 months after treatment, significantly higher than that in A1 group, with 31.6% （P 〈0. 05） . No severe side effect was observed in both groups. Conclusion Alondronate could increase BMD in hyperthyroid osteoporosis without severe side effect.