鲑鱼降钙素联合唑来膦酸注射液治疗老年原发性骨质疏松症的疗效观察

Efficacy of salmon calcitonin combined with zoledronic acid in treatment osteoporosis

对2012年1月至2013年4月在我院接受诊治的120例老年原发性骨质疏松症患者（男41例，女性79例），除常规补充钙剂外，60例采用鲑鱼降钙素联合唑来膦酸注射液治疗（观察组），60例采用阿仑膦酸钠治疗（对照组）。药物剂量为肌肉注射鲑鱼降钙素50u／次、1次／d，连用1周，1周后为100U／次、隔天1次，连用1周，之后静滴唑来膦酸注射液5mg、1次／年；口服阿仑膦酸钠70mg／次、1次／周。两组患者分别于治疗前、治疗1、6及12个月时行视觉模拟评分法（VAS）评分，于治疗前和治疗12个月时行sF-12健康调查量表和骨密度（BMD）水平检测。治疗前、治疗6及12个月时两组VAS评分差异无统计学意义（均P〉0．05），但治疗后VAS评分均低于治疗前，差异有统计学意义（P〈0．05）；治疗1个月时观察组VAS评分低于对照组[（2．1±3．0）与（4．2±3．1）分]，差异有统计学意义（P〈0．05）；治疗前后两组SF-12健康调查量表[躯体评分治疗前（38．9±8．3）与（39．2±7．8）分、治疗12个月（48．2±4．3）与（47．9士5．7），心理评分治疗前（44．3±5．9）与（45．2±6．3）分、治疗12个月（55．1±5．7）与（54．8±7．1）分]、骨密度值比较[治疗前（0．68±0．07）与（0．67±0．08）g／em。，治疗后（0．79±0．06）与（0．78±0．07）g／em。]，差异均无统计学意义（P〉0．05），但均优于治疗前，差异有统计学意义（均P〈0．05）；观察组不良反应发生率低于对照组（16％与20％），差异有统计学意义（P〈0．05）。提示，鲑鱼降钙素联合唑来膦酸注射液治疗老年原发性骨质疏松症疗效显著，安全可靠、耐受性好，但中、远期疗效有待进一步观察。

One hundred and twenty patients with senile primary osteoporosis were enrolled in the study from January 2012 to April 2013, including 41 males and 79 females. Patients were randomly assigned to two groups： 60 patients in study group were treated with salmon calcitonin combined with zoledronic acid （ salmon ealcitonin 50 IU i. m, q. d for 7 d, then 100 IU q. i. d for 7 d, followed by zoledronic acid 5 mg i. v gtt/y） ; 60 cases in control group were treated with alendronate （70 mg p. o/wk）. Both groups received the same doses of calcium. Visual analogue scale （VAS） scores were assessed before, and 1, 6 and 12 months after treatment, 12-Item Short-Form Health Survey （SF-12） and bone mineral density （BMD） were assessed before and 12 months after treatment. There were no significant differences in all baseline parameters between two groups （ P 〉 0. 05 ）. After 1 month of treatment, the VAS scores of study group was ! lower than that of the control group （ 2.1：1：3.0 vs. 4.2：1： 3.1, P 〈 0.05 ）, however, both groups had similar improvements in VAS scores in 6 and 12 months after the treatment （ P 〉 0.05 ）. Compared to those before treatment, physical component summary and mental component summary of SF-12 scores after 1 year of treatment were improved significantly in both groups （P 〈 0.05 ）. Also, BMD was significantly improved after 1 year of treatment in both groups （P 〈 0. 05 ）. The incidence of side effect in study group was lower than that in control group （16% vs. 20%, P 〈 0.05 ）. The results indicate that salmon calcitonin combined with zoledronic acid is an effective, safe, reliable and well tolerated therapy for senile primary osteoporosis. The long-term outcomes remain to be determined.