氯膦酸二钠联合骨化三醇治疗绝经后骨质疏松的疗效及对血清IGF-BP-3、SHBG的影响

Curative efficacy of disodium chlorophosphonate combined with calcitriol in treatment of postmenopausal osteoporosis and effects on serum IGF-BP-3 and SHBG levels

目的探讨氯膦酸二钠联合骨化三醇治疗绝经后骨质疏松的疗效及对血清胰岛素样生长因子结合蛋白-3(IGF-BP-3)、性激素结合蛋白(SHBG)的影响。方法选择2016年1月~2018年4月铁岭市中心医院接诊的90例绝经后骨质疏松患者,通过随机数表法分为观察组50例和对照组40例。在常规治疗基础上,对照组给予骨化三醇治疗,观察组联合氯膦酸二钠治疗,均连续治疗6个月。比较两组临床疗效、血清IGF-BP-3、SHBG、实验室指标、骨密度及不良反应。结果治疗后,观察组临床疗效总有效率明显高于对照组(P<0.05);观察组IGF-BP-3明显高于对照组,SHBG低于对照组低(P<0.05);观察组血清骨钙素、血磷、碱性磷酸酶、骨保护素(OPG)、核因子-kβ受体活化因子配体(RANKL)均明显低于对照组,血钙明显高于对照组(P<0.05);观察组腰椎L2~4、股骨颈骨密度均明显高于对照组(P<0.05);两组治疗期间均未出现明显不良反应。结论氯膦酸二钠联合骨化三醇治疗绝经后骨质疏松效果显著,可有效调节血清IGF-BP-3、SHBG的表达,增加骨密度,且安全性高,可在临床推广应用。

bjective To study the curative efficacy of disodium chlorophosphonate combined with calcitriol in treatment of postmenopausal osteoporosis and effects on serum insulin-like growth factor binding protein-3(IGF-BP-3)and sex hormone binding protein(SHBG)levels.Methods 90 patients of postmenopausal osteoporosis received therapy from January 2016 to April 2018 in our hospital were selected as research objects,according to the random number table.Those patients were divided into observation group(50 cases)and control group(40 cases).On the basis of routine treatment,the control group was treated with calcitriol,while the observation group was treated with disodium chlorophosphonate.They were treated continuously for 6 months.The clinical efficacy,serum IGF-BP-3,SHBG,laboratory indexes,bone mineral density and adverse reactions were compared between the two groups.Results After treatment,the total effective rate in the observation group was significantly higher than those in the control group(P<0.05).The IGF-BP-3 in observation group was significantly higher than those in control group.SHBG was significantly lower than those in control group(P<0.05).The serum osteocalcin,phosphorus,alkaline phosphatase,osteoprotegerin(OPG),Nuclear Factor-kβReceptor Activator Ligand(RANKL)in the observation group were significantly lower than those in the control group,and the serum calcium was significantly higher than those in control group(P<0.05).The bone mineral density of lumbar vertebrae L2~4 and femoral neck in the observation group was significantly higher than those in the control group(P<0.05).There were no obvious adverse reactions during the treatment.Conclusion Disodium chlorophosphonate combined with calcitriol is well for postmenopausal osteoporosis,which can effectively regulate the expression of serum IGF-BP-3 and SHBG,increase bone mineral density,and has high safety.