74例老年骨质疏松患者应用鲑鱼降钙素联合阿仑膦酸钠治疗的疗效观察

The observation of the effect of salmon calcitonin combined with alendronate sodium on the treatment of senile osteoporosis

目的评估联合应用鲑鱼降钙素与阿仑膦酸钠治疗缓解老年性骨质疏松症患者骨关节疼痛及血清骨钙素(BGP)、降钙素(CT)及骨密度(BMD)水平的变化。方法联合应用鲑鱼降钙素和阿仑膦酸钠治疗本院收治的74例老年性骨质疏松症患者,给予鲑鱼降钙素50IU肌肉注射,隔日1次,连续使用15次后改为口服阿仑膦酸钠1粒/周,共经6个月治疗,采用数字模拟评分法(VAS)比较治疗前、后全身骨关节疼痛程度,治疗前、后骨钙素、降钙素及第2～第4腰椎(L2-4)、股骨颈、Ward区骨密度水平的变化,并进行统计学分析。结果鲑鱼降钙素联合阿仑膦酸钠治疗老年性骨质疏松症患者6个月后,对缓解骨关节疼痛症状疗效良好,治疗前与治疗后比较差异显著(P<0.01);治疗前后骨密度、血清骨钙素和降钙素水平均有显著差异(P<0.05)。结论鲑鱼降钙素联合阿仑膦酸钠治疗老年性骨质疏松症使血清降钙素的水平明显升高,骨钙素水平明显降低,能显著减轻患者骨关节疼痛,改善症状,并增加骨密度,对老年性骨质疏松症有明显的疗效。

Objective To evaluate the effect of salmon calcitonin combined with alendronate sodium on bone and joint pain, and to observe the changes of bone mineral density （BMD）, and the serum concentrations of bone Gla protein （BGP） and calcitonin （CT） in senile osteoporosis patients. Methods Seventy-four senile osteoporosis patients in our hospital were treated with salmon calcitonin combined with alendronate sodium. All of them were given an intramuscular injection of 50 IU salmon calcitonin once every other day. After 15 continuous injections, they were given an oral medication of 1 capsule alendronate sodium once a week. The whole treatment lasted for 6 months. The degree of bone and joint pain before and after treatment was estimated with visual analogue scale （VAS）. BMD of the lumbar vertebrae （L2-L4） , the femur neck, and Wards region was tested before and after the treatment. Serum concentrations of BGP and calcitonin were tested before and after the treatment. All the results were statistically analyzed. Results After 6-month treatment with salmon calcitonin combined with alendronate sodium in senile osteoporosis patients, the relief of pain in bone and joint was obvious, and the difference was significant （ P 〈 0.01 ）. BMD and the serum concentrations of BGP and calcitonin after the treatment were significantly different from those before the treatment （ P 〈 0. 05 ）. Conclusion The treatment with salmon calcitonin combined with alendronate sodium in senile osteoporosis patients can significantly improve BMD and serum concentration of calcitonin, and can reduce the serum concentration of bone Gla protein, relieve bone and joint pain in patients, ameliorate the symptoms, and increase BMD. It has an evident efficacy on senile osteoporosis.