阿仑膦酸钠在类风湿关节炎患者的应用及骨密度的变化

Effect of alendronate on bone mineral density in patients with rheumatoid arthritis

目的观察阿仑膦酸钠在活动性类风湿性关节炎(RA)患者的疗效,及其对骨密度的影响。方法将100例RA患者分成治疗组和对照组。两组均予强的松、甲氨喋呤及羟基氯喹等治疗,治疗组在此基础上加用阿仑膦酸钠治疗。记录两组患者临床、实验室指标及骨密度。结果治疗24周后,治疗组患者髋部及腰椎骨密度较治疗前、对照组均有明显改善(P<0.01),而对照组治疗前后骨密度改善不明显(P>0.05)。两组治疗24周后ACR20、ACR50、ACR70差异均无统计学意义(均P>0.05)。结论阿仑膦酸钠能有效提高活动性RA患者骨密度水平,但未发现有增强临床疗效的作用。

Objective To observe the efficacy of alendronate in patients with active rheumatoid arthritis（RA）and its effect on bone mineral density.Methods One hundred patients with RA were divided into the treatment group and the control group,both groups were received treatment with prednisone,methotrexate and hydroxychloroqu-ine.The treatment group was added with alendronate.Clinical and laboratory data and bone mineral density of two groups were recorded.Results Twenty-four weeks after treatment,hip and lumbar spine bone density were obvio-usly improved（ P〈0.01） in the treatment group,while bone mineral density did not change significantly（ 〉0.05） in the control group.ACR20,ACR50 and ACR70 were not significantly different（ 〉0.05） between two groups after treatment.Conclusions Alendronate can effectively improve the level of bone mineral density in patients with active RA,but it can＇t enhance its clinical efficacy.