阿仑膦酸钠与阿法骨化醇联合治疗老年2型糖尿病骨质疏松患者疗效及骨代谢分析

Therapeutic Effect and Bone Metabolism in Elderly Patients with Type 2 Diabetes Mellitus with Osteoporosis Treated with Alendronate Combined with Alfacalcidol

目的:探讨阿仑膦酸钠与阿法骨化醇联合应用对老年2型糖尿病骨质疏松患者骨密度、骨代谢及疗效情况。方法:随机选取本院96例老年2型糖尿病合并骨质疏松患者进行研究,按照随机数字表法分为对照组与试验组,均为48例,对照组患者常规补钙治疗(碳酸钙D3),试验组在补钙治疗基础上加用阿仑膦酸钠(10 mg/次,1次/d,口服6个月)联合阿法骨化醇(0.5μg/次,1次/d,口服6个月)治疗。两组患者均连续治疗6个月,分别于治疗前及治疗后6个月测定L2、L3、L4及股骨颈骨密度变化,血清BALP、TRAP-5b水平变化,采用VAS评分系统对自发性痛、屈伸痛、翻身痛及负重痛进行评估,统计治疗总有效率,并行安全性分析。结果:两组治疗前L2、L3、L4及股骨颈骨密度,血清BALP、TRAP-5b水平,自发性痛、屈伸痛、翻身痛及负重痛的VAS评分比较,差异均无统计学意义(P>0.05)。治疗6个月后,两组L2、L3、L4及股骨颈骨密度均明显提高,且试验组各部位骨密度均明显高于对照组(P<0.05)。治疗后6个月,两组BALP、TRAP-5b水平均降低(P<0.05),且试验组各指标均低于对照组(P<0.05)。治疗后两组各项VAS评分均呈下降趋势(P<0.05),且试验组疼痛程度评分低于对照组(P<0.05)。试验组总有效率为97.92%,对照组为83.33%,差异有统计学意义(P<0.05)。两组患者不良反应少,血糖稳定。结论:阿仑膦酸钠联合阿法骨化醇对老年2型糖尿病骨质疏松患者疗效确切,血糖稳定,可改善骨密度及骨代谢,安全性高。

Objective：To analyze the therapeutic effect and bone metabolism in elderly patients with type 2 diabetes mellitus with osteoporosis treated with Alendronate combined with Alfacalcidol.Method：Ninety-six patients with type 2 diabetes mellitus with osteoporosis in our hospital were randomly selected and divided into the control group and the experimental group according to the random number table method principle,each had 48 cases.The control group was treated with conventional calcium treatment（Calcium Carbonate D3）,on the basis of Calcium treatment the experimental group was treated with Alendronate（10 mg/times,1 time/d,orally for 6 months） combined with Alfacalcidol（0.5 μg/time,1 time/d,orally for 6 months ） treatment.Respectively before treatment and after 6 months,L2,L3,L4 and femoral neck BMD changes,serum levels of BALP and TRAP-5b levels were determined,spontaneous pain,flexion and extension pain,turn over weight and pain pain had been adopted by VAS scoring system to assess,and analyzed the total effective rate of treatment.Result：L2, L3,L4 and femoral neck bone density,serum BALP,TRAP-5b levels,spontaneous pain,flexion and extension pain,turning over pain and weight bearing pain VAS scores of two groups were no significant differences before treatment（P〉0.05）.L2,L3,L4 and femoral neck bone density after 6 months of treatment were improved than those of before treatment,and the experimental group were higher than those of the control group （P〈0.05）.BALP, TRAP-5b levels of patients were reduced after treatment （P〈0.05）,and the test group was lower（P〈0.05）.After treatment,the VAS scores of two groups were decreased（P〈0.05）,and the pain scores of the experimental group were lower than those of the control group （P〈0.05）.The treatment efficiency of the experimental group was 97.92%, the control group was 83.33%,the former was higher（P〈0.05）.Two groups of patients had less adverse reactions, stable blood glucose.Conclusion：Effect and bone metabolism in elderly patients with type 2 diabetes mellitus with osteoporosis treated with Alendronate combined with Alfacalcidol is exactly and the blood glucose stability,bone mineral density and bone metabolism are significantly improved,and the safety of the treatment is high.