脉冲电磁场对脊髓损伤患者骨量丢失的影响

The effect of pulsed electromagnetic fields on bone loss in spinal cord injured patients

目的探讨脉冲电磁场（PEMFS）治疗对脊髓损伤（SCI）患者骨量丢失的影响。方法将入选的SCI患者55例按随机数字表法分为治疗组（29例）和对照组（26例），对照组患者给予常规康复治疗；治疗组患者在常规康复治疗的基础上加用PEMFS治疗。2组患者均于治疗前和治疗12周后（治疗后）评定其骨密度和骨代谢生化指标。结果治疗后，治疗组患者仅转子间的骨密度（0．827±0．103）g／cm2与组内治疗前的（0．796±0．092）g／cm2比较，差异无统计学意义（P〉0．05），其股骨颈、大转子、Ward’s三角区以及总的骨密度值分别为（0．594±0．110）g／cm2、（0．671±0．109）g／cm2、（0．396±0．106）g／cm2、（0．679±0．123）g／cm2、较组内治疗前均显著增加（P〈0．05），且股骨颈、大转子、转子间、Ward’s三角区以及总的骨密度值均明显高于对照组治疗后（P〈0．05）。治疗后，治疗组的血清骨钙素（BGP）、尿吡啶啉／肌酐（U-Pyd／Cr）和1，25-二羟基维生素D3[1，25（OH），D，]3项生化指标分别为（5．76±0．35）ng／ml、（21．6±2．51）nm／ml和（10．5±2．75）ng／ml，与组内治疗前和对照组治疗后比较，差异均有统计学意义（P〈0．05）。结论脉冲电磁场可延缓SCI患者的骨量丢失．预防和治疗骨质疏松症。

Objective To observe any therapeutic effect of pulsed electromagnetic fields （PEMFs） on bone loss in spinal cord injury （SCI） patients. Methods Fifty-five patients with SCI were divided into two groups randomly. The twenty-six patients in the control group （ group B） were given only routine rehabilitation treatment; the twenty-six patients in the treatment group （group A） received PEMF therapy in addition. Results After 12 weeks of treatment, the average bone mineral density （BMD） of the proximal femur （including total, neck, Wards, inter, troth） in group A was significantly higher than in group B. The levels of bone-gamma-carboxyglutamic acid containing protein （BGP） and 1,25 （OH）2D3 in group A increased significantly, while they decreased in group B. Urine-pyridinium/crealinine （U-Pyd/Cr） levels in group A decreased significantly, while in group B they were higher than before. There were statistically significant differences between the two groups. Conclusion PEMF treatment can effectively retard bone loss in SCI patients. It has good preventive and curative effects on osteoporosis after SCI.