唑来膦酸治疗老年性骨质疏松的临床观察

Therapeutic effect of zoledronic acid on primary ostsoporosis in elderly patients

目的观察唑来膦酸(密固达)在治疗老年性骨质疏松中骨密度与骨代谢指标的变化。方法对48例老年性骨质疏松患者随机分为治疗组23例,对照组25例,两组均每日口服维生素D3与钙尔奇-D,治疗组加予密固达5 mg静脉滴注1次,1年后观察两组骨密度与骨代谢指标的变化。结果治疗前两组无差异(P>0.05)。治疗后,治疗组L1-4、Neck、Inter、Ward's骨密度均比对照组明显增加(P<0.05),β-胶原片段(β-CTX)较对照组下降(P<0.05),骨钙素(N-MID)、降钙素(hCT)与对照组相比无明显差异(P>0.05)。结论静滴1次密固达,1年后能有效地降低骨吸收,提高骨密度,可用于治疗老年性骨质疏松。

Objective To observe the effect of zoledronic acid on bone mineral density （BMD） and bone metabolic markers in elderly patients with primary osteoporosis. Methods Forty-eight elderly patients with osteoporosis were randomly assigned to zoledronic acid group （n=23） to receive treatment with 5 mg zoledronic acid once a year and the control group （n=25）. In both groups, the patients were given Vitamin D3 and caltrate on a daily basis for a year. The bone mineral density （BMD） and bone metabolic markers were observed after the treatment. Results Compared with the control group, zoledronic acid group had significantly higher L1-4, neck, Inter and Ward＇s BMD （P〈0.05） with reduced B-NTX （P〈0.05）. The N-MID and CT showed no significant differences between the two groups （P〉0.05）. Conclusion Zoledronic acid administration once a year can increase BMD and lower the serum bone turnover metabolism, and can be used in the treatment of primary osteoporosis in elderly patients.