胶原肽联合钙尔奇D治疗绝经后骨质疏松患者疗效分析

Effects of collagen peptide combined with caltrate D on the treatment of postmenopausal osteoporosis

目的研究胶原肽联合钙尔奇D对绝经后骨质疏松患者的疗效。方法 202例绝经后骨质疏松症患者随机分为试验组(每日口服胶原肽10 g联合钙尔奇D 600 mg)和对照组(口服钙尔奇D 600 mg),进行为期6个月的治疗。利用化学发光法检测血清总骨1型前胶原N端肽(N-propeptide of type 1 collagen,PINP)、β-I型胶原交联羧基末端肽(C-terminal crosslinked telopeptides of type 1 collagen,β-CTX)、血清骨钙素(osteocalcin,OC)、25-羟维生素D3[25 hydroxy vitamine D3,25(OH)D3]、甲状旁腺素(parathyroid hormone,PTH)。利用双能X线(dual energy X-ray absorptiometry,DXA)吸收法进行腰椎、股骨骨密度(bone mineral density,BMD)检测。结果治疗6个月后,口服胶原肽联合钙尔奇D能够更有效地缓解骨质疏松导致的骨痛。试验组患者血清PTH、25(OH)D3及OC水平明显高于治疗前(P<0.01)及对照组(P<0.01)。对照组患者治疗后血清PINP水平明显低于治疗前(P<0.01),而PTH、25(OH)D3、β-CTX水平明显高于治疗前(P<0.01)。试验组患者治疗后血清PINP水平明显高于对照组(P<0.01),而β-CTX水平低于对照组(P<0.05)。试验组患者腰椎L_2、L_4及股骨颈、粗隆间BMD明显高于治疗前(P<0.01)及对照组(P<0.05)。试验组患者各部位BMD均显著高于治疗前(P<0.01);而对照组患者治疗后上述各指标差异无统计学意义(P>0.05)。结论口服胶原肽联合钙尔奇D既能促进骨形成,又能抑制骨吸收,进一步增加BMD,并且可以缓解骨质疏松引起的疼痛。

Objective To study the effects of bone collagen peptide combined with Caltrate D on the treatment of postmenopausal osteoporosis. Methods 202 postmenopausal women with osteoporosis were randomized to receive oral administration of 10 g collagen peptide combined with 600 mg Caltrate D(experimental group) or 600 mg Caltrate D(control group) daily for 6 months. Serum total N-terminal propeptide of type I procollagen(PINP),β-isomerized C-terminal cross-linked telopeptide of type I collagen(β-CTX), N-MID Osteocalcin(OC), 25-hydroxyvitamin D3(25-OH D3) and parathyroid hormone(PTH) were detected by chemiluminescence. BMD of the lumbar spine and the femur was measured using dual-energy X-ray absorption. Results After 6 months of treatment, oral collagen peptide combined with Caltrate D was more effective in alleviating bone pain caused by osteoporosis. The levels of serum PTH, 25-OH D3 and N-MID Osteocalcin(OC) in the experimental group were significantly higher than those before treatment(P<0.01) and the control group(P<0.01). Serum PINP level of the control group after treatment was significantly lower than that before treatment(P<0.01), while the levels of PTH, 25-OH D3 and β-CTX were significantly higher than those before treatment(P<0.01). Serum PINP level in the experimental group was significantly higher than that in the control group(P<0.01), while the level of β-CTX in the experimental group was lower than that in the control group(P<0.05). BMD of L2-L4 of lumbar spine and of femoral neck and intertrochanter of femur in the experimental group was significantly higher than that before treatment(P<0.01) and the control group(P<0.05). BMD of all sites in the experimental group was significantly higher than that before treatment(P<0.01), but there was no statistical significance in the above indexes after treatment in the control group(P>0.05). Conclusion Oral collagen peptide combined with Caltrate D not only could promote bone formation, but also could inhibit bone absorption, further increase BMD and alleviate the pain caused by osteoporosis.