唑来膦酸治疗原发性骨质疏松症临床疗效研究

Clinical Efficacy Research of Zoledronate Primary Osteoporosis Acid Treatment

目的：探讨唑来膦酸联合钙尔奇D治疗原发性骨质疏松症临床疗效及安全性。方法：唑来膦酸注射液4mg，用0．9％氯化钠注射液或5％葡萄糖注射液100ml稀释后静脉滴注，滴注时间≥15min。同时口服钙尔奇D片600mg，1次／d，疗程为12个月。结果：本组43例患者经唑来膦酸联合钙尔奇D治疗6个月、12个月后骨痛症状明显改善，较治疗前骨痛NRS评分明显降低，差异有统计学意义（P〈0．05），腰椎L1-4。与股骨颈骨密度（BMD）值，较治疗前有明显增长，差异有显著性（P〈0．05），而患者血钙（Ca）、血磷（P）检测值与治疗前比较无明显变化，差异无统计学意义（P〉0．05），骨形成标志物OC、BALP值下调，治疗后12个月两者测定接近于正常值，其中OC值治疗后12个月较治疗前下降明显，差异有统计学意义（P〈0．05）；而骨吸收标志物β-CTx、DPD／Cr比值，治疗后下降迅速，与治疗前比较，差异具有显著性（P〈0．05）。结论：唑来膦酸联合钙尔奇D治疗原发性OP可有效改善骨痛症状与骨代谢相关指标，增加骨量，不良反应少，患者依从性较好。

Objective： To discuss zoledronate （ZOD） with Caltrate D in primary clinical efficacy and safety of osteoporosis. Methods： Zoledronate Acid Injection 4mg,with 0. 9% sodium chloride injection or 5% glucose injection 100ml diluted intravenous infusion, at the same time oral Caltrate D 600rag, 1time/d, period of treatment is 12 months. Results： This group of 43 patients treated by zoledronate （ZOD） joint Caltrate D treatment for 6 months, 12 months after the pain symptoms improved, compared with those before treatment NRS pain scores decreased significantly, the difference was statistically significant （P〈0. 05）, Lumbar L1-4 and femoral neck bone mineral density （BMD）numerical, there are obviously increased compared with before treatment, there were significant differences （P〈0. 05）, the serum calcium （Ca）, phosphorus （P） detection value have no significant difference compared with before treatment, the difference was not statistically significant （P〉0. 05）, bone formation markers OC, BALP value reduced smooth, after 12 months of treatment both measured close to normal, the difference was statistically significant （P〈0. 05）; bone resorption markers β-CTx, DPD/Cr ratio, and decreased after the treatment quickly, compared with before treatment, the differ- ence was significant （P〈0. 05）. Conclusion： Zoledronate combined with Caltrate D treatment of primary osteoporosis can be effective in improving the symptoms of pain associated with bone metabolism indicators, increase the bone mass, less adverse reaction, patient compliance is good.