维生素K联合骨化三醇、钙尔奇D治疗男性骨质疏松的疗效观察

Therapeutic effect of vitamin K combined with calcitriol and Caltrate plus D on osteoporosis in males

目的研究维生素K联合骨化三醇、钙尔奇D对男性骨质疏松的治疗效果及对骨代谢的影响。方法采用美国Hologic公司生产的Discovery WA型双能X线骨密度仪检测患者腰椎L1~4骨密度(bone mineral density,BMD)与股骨颈骨密度。对男性骨质疏松患者采用固力康联合骨化三醇、碳酸钙D3进行治疗,连续治疗1年,治疗期间监测患者骨代谢变化。采用美国Thermo公司全自动酶标免疫分析仪检测患者血清骨代谢指标BGP、CTX-1、细胞因子IL-6、IL-10水平。结果治疗6个月后患者腰椎(L1-4) BMD、股骨颈BMD开始增加,治疗12个月后患者腰椎(L1-4) BMD、股骨颈BMD较治疗前增加明显。治疗后,血清骨形成指标BGP水平升高、细胞因子IL-10水平升高;血清骨吸收指标CTX-1水平、细胞因子IL-6水平降低。结论维生素K可提高患者腰椎与股骨颈骨密度,升高血清骨形成指标BGP、细胞因子IL-10水平,降低血清骨吸收指标CTX-1、细胞因子IL-6水平,维生素K治疗男性骨质疏松效果显著,是临床上治疗骨质疏松的重要策略之一。

Objective To study the therapeutic effect of vitamin K combined with calcitriol and Caltrate plus D on male osteoporosis and the effect on bone metabolism. Methods Using the Discovery WA model dual-energy X-ray absorptiometer(Hologic,USA) to detect lumbar spine L1-4 bone density and femoral neck bone density. Male osteoporosis patients were treated with Gulikang combined with calcitriol and calcium carbonate plus vitamin D3 for one year. Thermo Scientific’s fully automated enzyme-labeled immunoassay analyzer was used to detect patients’ bone metabolism indicators including BGP,CTX-1,cytokines IL-6 and IL-10 levels in serum.Results After 6 months of treatment,lumbar vertebrae(L1-4) BMD and femoral neck BMD began to increase. After 12 months of treatment,lumbar vertebrae(L1-4) BMD and femoral neck BMD increased significantly compared with before treatment. After treatment,serum bone formation index BGP and cytokine IL-10 levels increased,and serum bone resorption index CTX-1 and cytokine IL-6 levels decreased. Conclusion Vitamin K could increase the bone density of lumbar spine and femoral neck and increase serum bone formation markers BGP and cytokine IL-10 levels,while decrease serum bone resorption index CTX-1 and cytokine IL-6 levels.The effect of vitamin K treatment on male osteoporosis was significant,and it could be an important strategy for the treatment of osteoporosis clinically.