摘要
目的:探讨运用锝(99 Tc)亚甲基二磷酸盐注射液联合辛伐他汀治疗类风湿关节炎继发骨质疏松临床疗效。方法:选取我院2012年-2013年住院部明确诊断为类风湿关节炎(RA)继发骨质疏松(OP)患者106例,随机分为4组:对照组采取2种及以上慢作用抗风湿药物(如甲氨喋呤、来氟米特、柳氮磺氨吡啶、硫酸羟氯喹、白芍总苷等)治疗,同时采用口服钙剂及活性维生素D3,治疗1组在对照组基础上加用锝(99 Tc)亚甲基二磷酸盐注射液及口服辛伐他汀治疗;治疗2组在对照组基础上加用锝(99 Tc)亚甲基二磷酸盐注射液治疗,治疗3组在对照组基础上加用辛伐他汀治疗。总疗程6个月。观察治疗前后骨密度(桡-BMD、腰-BMD)、骨合成指标(ALP)、C反应蛋白(CRP)、类风湿因子(RF)、血沉(ESR)、血脂、血钙、血磷、肝肾功能等相关指标。结果:治疗6个月后显示,治疗1组患者BMD显著增加,ALP显著改善,治疗前后比较差异有统计学意义(P<0.05),优于治疗2、3组,且治疗2组优于治疗3组。对照组治疗后BMD、ALP指标较前改善,但差异无统计学意义(P>0.05)。4组治疗前后RF、CRP、ESR等指标明显下降,差异有统计学意义(P<0.05)。结论:锝(99 Tc)亚甲基二磷酸盐注射液联合辛伐他汀能显著增加RA患者BMD,明显改善患者的OP,提高患者生活质量。
Objective:To explore the clinical efficacy of technetium(^99Tc)methylene diphosphate injection combined with simvastatin for osteoporosis secondary to rheumatoid arthritis.Methods:From 2012 to 2013,106 patients with osteoporosis OP)secondary to rheumatoid arthritis(RA)were randomly divided into four groups.The control group were treated with two kinds or more slow-acting anti-rheumatic drugs(such as methotrexate,leflunomide,sulfasalazine fampridine,hydroxychloroquine sulfate,TGP),oral calcium and active vitamin D3 being used at the same time.The treatment group1 underwent technetium(^99 Tc)methylene diphosphate injection and oral simvastatin based on the control group.The treatment group2 underwent technetium(^99Tc)methylene diphosphate injection and the treatment group3 added with oral simvastatin.The total course is six months.BMD(radial-BMD,waist-BMD),bone synthesis index(ALP),C-reactive protein(CRP),rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),lipids,calcium,phosphorus,liver kidney function and other related indicators were observed before and after treatment.Results:After 6months of treatment,BMD in combined treatment group increased significantly and ALP was also significantly improved.The difference was statistically significant before and after treatment(P〈0.05),which is better than that in monotherapy group.And the therapeutic effect of single technetium(^99Tc)methylene diphosphate injection is better than that of simvastatin group.The BMD and ALP indicators of control group after treatment was improved but it showed no significant difference(P〈0.05).RF,CRP,ESR and other indicators decreased in four groups after treatment and it showed statistical significance(P〈0.05).Conclusion:Technetium(^99Tc)methylene diphosphate injection combined with simvastatin can significantlyincrease BMD of RA patients and improve the patient's OP and the quality of life significantly.
出处
《中国中医骨伤科杂志》
CAS
2015年第2期24-27,共4页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
湖北省荆门市自然基金(2013S03)