唑来膦酸联合特立帕肽治疗绝经后骨质疏松症对骨密度影响的临床观察

Clinical effects on bone mineral density through intravenous zoledronic acid plus subcutaneous teriparatide for postmenopausal osteoporosis

目的观察唑来膦酸联合特立帕肽治疗绝经后骨质疏松症对骨密度(BMD)的影响。方法 60例绝经后骨质疏松症患者随机分成唑来膦酸组、特立帕肽组和特立帕肽+唑来膦酸组,观察各组用药后13、26和52周时腰椎、髋部和股骨颈BMD相对于基线的变化。结果特立帕肽+唑来膦酸组用药后13和26周的腰椎BMD增长百分比与唑来膦酸组、特立帕肽组相比存在显著差异(P<0.01)。用药后52周,特立帕肽+唑来膦酸组与特立帕肽组腰椎BMD无统计学差异,但显著高于唑来膦酸组(P<0.01)。唑来膦酸组、特立帕肽+唑来膦酸组用药后13、26和52周的髋部和股骨颈BMD增长百分比与特立帕肽组相比,差异有统计学意义(P<0.05),特立帕肽+唑来膦酸组用药后13周的髋部BMD增长百分比与唑来膦酸组相比,差异有统计学意义(P<0.05)。结论唑来膦酸和特立帕肽联合治疗对提高绝经后骨质疏松症患者的BMD有益。

Objective To evaluate the effects on bone mineral density（BMD） through intravenous zoledronic acid plus subcutaneous teriparatide in postmenopausal osteoporosis.Methods A total of 60 postmenopausal women with osteoporosis were randomized to receive zoledronic acid alone,teriparatide alone and a single infusion of zoledronic acid plus daily subcutaneous teriparatide.The endpoint percentage increase in BMD of lumbar spine,total-hip and femoral neck at 13,26 and 52 weeks versus baseline was observed.Results At week 52,there was significant difference between combination and teriparatide alone in increase BMD of lumber spine versus zoledronic acid alone（P0.01）.In the combination group,spine BMD increased more rapidly than with either agent alone versus both teriparatide and zoledronic acid at 13 and 26 weeks（P0.01）.Combination therapy and zoledronic acid alone increased total-hip and femoral neck BMD more than teriparatide alone at all times（P0.05）.Combination therapy increased total-hip BMD more than zoledronic acid alone at 13 weeks（P0.05）.Conclusion The combination therapy of intravenous zoledronic acid plus subcutaneous teriparatide can take additive effects in postmenopausal osteoporosis.