利塞膦酸钠对糖皮质激素诱导的骨质疏松的疗效观察

Efficacy of Risedronate in the Treatment of Corticosteroid-induced Osteoporosis

目的研究利塞膦酸钠对长期服用糖皮质激素患者骨代谢的影响。方法采用随机、双盲、安慰剂对照研究,40例长期服用糖皮质激素患者分为治疗组和对照组,治疗组利塞膦酸钠给药5 mg.d-1,对照组等剂量给予安慰剂治疗。每位受试者在服药前及服药后12个月分别检测1次骨密度(BMD)、血生化指标及骨代谢标志物。结果与对照组相比,利塞膦酸钠能显著增加受试患者BMD,并显著降低血清骨钙素及尿I型胶原交联氨基端肽。结论利塞膦酸钠可防止糖皮质激素诱导的骨丢失,降低骨转换、改善骨密度,是治疗糖皮质激素诱导的骨质疏松的安全和有效的药物。

OBJECTIVE To study the bone metabolism in corticosteroids-treated patients with risedronate treatment. METHODS Forty ambulatory patients who took high-dose corticosteroids therapy, were randomly, double-blindly divided into two groups： treatment group （20 patients） were treated with risedronate sodium（5 mg.d-1） and control group（20 patients） were treated with placebo for 12 months. The efficacy of the treatment was evaluated by bone mineral density（BMD） measurements at spine and hip at the 12th month of the treatment and by the measurement of bone turnover marks. RESULTS After 12 months, in treatment group, BMD in the lumbar vertebrae and hip was significantly increased, and bone turnover marks ameliorated significantly compared with control group. CONCLUSION The risedoronate can increase BMD and ameliorate bone metabolism in patients with corticosteroids-induced osteoporosis.