鲑鱼降钙素对绝经后骨质疏松性椎体骨折的治疗干预

Effects of Salmon Calcitonin On the Healing of Post-menopausal osteoporosis and Vertebrae Fractures of The Female

目的：探讨女性绝经后骨质疏松性椎体骨折的鲑鱼降钙素治疗效果。方法：（1）选择2006年3月至2008年2月武汉大学人民医院骨科女性绝经后骨质疏松性椎体骨折患者97例。患者被随机分为2组：对照组44例,治疗组（鲑鱼降钙素组）53例。（2）两组患者均行卧硬板床、腰背部或胸背部垫软枕,口服钙尔奇D片等治疗。鲑鱼降钙素组在对照组干预措施基础上给予鲑鱼降钙素肌注,50IU/1次/d,连续1个月。（3）分别于治疗前、治疗后1个月采用放射免疫分析法测定血骨钙素、收集晨起第2次尿,偶氮三胂法测定尿钙、化学发光免疫分析法测定尿羟脯氨酸、碱性苦味酸法测定尿肌酐,并计算尿钙/尿肌酐与尿羟脯氨酸/尿肌酐比值。（4）开始治疗后4,6,8周复查脊柱X光正侧位片,了解骨折愈合情况。（5）分别与治疗后2、4周以VAS法评定两组病人背痛缓解情况。结果：纳入患者97例中有2例因肌注密钙息出现面部潮红、头痛、恶心、呕吐、皮肤瘙痒等反应,于用药后3天左右终止治疗,最终进入结果分析95例。（1）所选患者治疗1个月后鲑鱼降钙素组血骨钙素明显高于治疗前（P≤0.01）;尿羟脯氨酸/尿肌酐比值明显低于治疗前（P≤0.01）。（2）治疗后4~6周复查X光片示鲑鱼降钙素组骨折愈合率达96.1%,对照组愈合率为79.5%。差异有显著性。（3）鲑鱼降钙素组、对照组分别有28例和17例患者于治疗2周后腰背疼痛消失,分别有43例和27例患者于用药后4周腰背痛消失。结论：鲑鱼降钙素能抑制骨质疏松患者的骨代谢,对骨吸收抑制的作用也很强;鲑鱼降钙素能够促进骨质疏松性椎体骨折的愈合,并能迅速改善腰背痛症状。

Objectives ： To probe the advangtages of treatment of post-menopausal osteoporosis vertebrae fractures with miacalcic.Methods ： 97 patients of post-menopausal osteoporosis vertebrae fractures were selected to investigate the therapeutic effects of Miacalcic and compared with control group.Miacalcic gr-oup were treated with injecting Miacalcic 50IU/d on top of routine orthopedic treatment,and patients of control group were only treated with basic orthpaedic treatment.Results ： A significant increase in serum bone glaprotein（BGP） were found in Miacalcic group（t = 3.002,P 0.01） and a significant decrease in urinary hydroxyproline/creatinine ratio（t = 7.21,P 0.01）,as compared to the control after one mon-th of treatment.The average time of fracture healing of Miacalcic group patients were shorter then that of control group.The back pain of Miacalcic group patients disappeared after four weeks of treatment.Conclusions： This study showed that Miacalcic was effective for the treatment of osteoporosis in post-men-opausal female and beneficial to the healing of fracture and reducing the back pain.