伊班膦酸钠对维持性血液透析骨质疏松患者骨密度的影响

Effects of ibandronate sodium on bone mineral density in maintenance hemodialysis patients with osteoporosis

目的探讨伊班膦酸钠对维持性血液透析骨质疏松或骨量低下患者的治疗作用。方法 20例维持性血液透析骨质疏松或骨量低下患者随机分为两组(各10例)。对照组血液透析3次/周,试验组在透析结束后加伊班膦酸钠静脉滴注,首次剂量1mg,后续为2mg/3个月,观察12个月。结果治疗12个月后,对照组患者腰椎骨密度降低了16.6%(P<0.01),试验组骨密度增加了2.9%,两组骨密度变化差异具有统计学意义(P<0.01);两组髋部骨密度均有降低,但试验组变化幅度显著低于对照组(P<0.01)。对照组和试验组钙、磷水平比较差异无统计学意义(P>0.05)。不同时间点血磷水平差异有统计学意义(P<0.05)。结论使用伊班膦酸钠可有效控制维持性血液透析患者骨量丢失,降低骨折风险。

Objective To evaluate the effects of ibandronate sodium on the treatment of maintenance hemodialysis（MHD） patients with osteoporosis or low bone mass. Methods Twenty MHD patients with osteoporosis or low bone mass were randomly divided into control group （ n = 10） and treatment group （ n =10）. Patients in the control group were treated with hemodialysis, three times per week. Patients in the treatment group received intravenous administration of ibandronate sodium immediately after hemodialysis with an initial dose of 1 mg and following dose of 2 mg every three months for i2 months. Results With 12 months＂ treatment of maintenance hemodialysis, patients in the control group got a decreased bone mineral density of the lumbar spine by 16.6%, which increased by 2.9% in the treatment group, showing significant difference between the two groups （ P 〈0.01）. The hip bone mineral densities in the two groups were both lower than that before treatment, especially in the treatment group （ P 〈0.01）. No significant differences of the serum calcium and phosphorus were found between the two groups （ P 〉 0.05）, but serum phosphorus showed significant difference among the different time points （ P 〈 0.01）. Conclusion Ibandronate sodium can effectively reduce the loss of bone mass and decrease the risk of bone fracture in MHD patients.