阿司匹林联合阿仑膦酸钠在骨质疏松治疗中的有效性及对病人骨密度的影响

Effectiveness of aspirin combined with alendronate in the prevention and treatment of osteoporosis and its effect on the bone density of patients

目的探讨在骨质疏松症病人中应用阿司匹林联合阿仑膦酸钠的效果及对病人骨密度的影响。方法将2017年1月至2018年6月西安交通大学第二附属医院收治的骨质疏松症病人92例按照随机数字表法分为观察组及对照组。两组病人均接受钙尔奇D片及阿法骨化醇软胶囊治疗,对照组病人在此基础上接受阿仑膦酸钠治疗,观察组病人在对照组病人治疗方案的基础上加服阿司匹林。比较两组病人治疗前及治疗后腰椎L2-L4、股骨颈、股骨大转子、Wards三角区骨密度及疼痛视觉模拟量表VAS得分;比较两组病人治疗前后中段骨钙素(N-MID),I型胶原C端肽(β-CTX)、骨保护蛋白(OPG)及骨形态发生蛋白-2(BMP-2)水平;比较两组病人治疗后的疗效。结果治疗后,观察组病人腰椎L2-L4、股骨颈、股骨大转子及Wards三角区骨密度均分别较治疗前升高[(0.726±0.083)比(0.605±0.067)g/cm2,(0.773±0.088)比(0.692±0.065)g/cm2,(0.658±0.049)比(0.559±0.038)g/cm2,(0.505±0.045)比(0.445±0.058)g/cm2,P<0.05],且均高于对照组病人(P<0.05);疼痛VAS得分较治疗前降低[(1.59±0.54)比(7.13±1.48)分,P<0.05)],且低于对照组病人(P<0.01);N-MID及β-CTX水平均分别较治疗前降低[(14.91±5.20)比(23.06±8.83)ng/mL,(0.34±0.04)比(0.58±0.04)ng/mL,P<0.05)],且均低于对照组病人(P<0.05);OPG及BMP-2水平均分别较治疗前升高[(248.50±56.88)比(177.39±47.45)pg/mL,(80.76±14.89)比(58.94±10.22)pg/mL,P<0.05)],且均高于对照组病人(P<0.01);观察组病人总有效率(95.7%)高于对照组病人(82.6%)(P<0.05)。结论在骨质疏松症病人中应用阿司匹林联合阿仑膦酸钠的效果显著。联合用药能够显著提高病人腰椎L2-L4、股骨颈、股骨大转子及Wards三角区骨密度,缓解病人的疼痛,有效抑制骨吸收、加快骨形成。

Objective To explore the effect of aspirin combined with alendronate on bone mineral density in patients with osteoporosis and its influence on bone mineral density.MethodsNinety-two patients with osteoporosis who were admitted to The Second Affiliated Hospital of Xi’an Jiaotong University from January 2017 to June 2018 were selected and assigned into the observation group and the control group according to the random number table method.All patients in both groups were received calcic D tablets and alfa-calcidol soft capsule treatment,patients in the control group were received alendronate treatment on this basis,while patients in the observation group were received aspirin on the basis of the treatment plan of patients in the control group.Before and after treatment,bone densities of lumbar spine L2-L4,femoral neck,femoral greater trochanter and Wards triangle,and VAS scores of pain sense were compared between the two groups.The levels of N-MID,β-CTX,OPG and BMP-2 in the two groups were compared before and after treatment.The efficacy of the two groups was compared after treatment.Results After treatment,the bone mineral densities of lumbar spine L2-L4,femoral neck,femoral greater trochanter and Wards triangle in the observation group were respectively higher than those before treatment[(0.726±0.083)vs.(0.605±0.067)g/cm2,(0.773±0.088)vs.(0.692±0.065)g/cm2,(0.658±0.049)vs.(0.559±0.038)g/cm2,(0.505±0.045)vs.(0.445±0.058)g/cm2,P<0.05],which were higher than those in the control group(P<0.05);the VAS score of pain sense in the observation group was lower than that before treatment[(1.59±0.54)vs.(7.13±1.48),P<0.05],which was lower than that in the control group(P<0.01);the levels of N-MID andβ-CTX in the observation group were lower than those before treatment[(14.91±5.20)vs.(23.06±8.83)ng/mL,(0.34±0.04)vs.(0.58±0.04)ng/mL,P<0.05],which were lower than those in the control group(P<0.05);the levels of OPG and BMP-2 were higher than those before treatment[(248.50±56.88)vs.(177.39±47.45)pg/mL,(80.76±14.89)vs.(58.94±10.22)pg/mL,P<0.05],which were higher than those in the control group(P<0.01).The total effective rate in the observation group(95.7%)was higher than that 82.6%of the control group(P<0.05).ConclusionsThe application of aspirin combined with alendronate in osteoporosis patients has a significant effect.Combined medication can significantly improve the bone density in the lumbar spine L2-L4,femoral neck,femoral greater trochanter and Wards triangle,alleviate pain in patients,effectively inhibit bone resorption and accelerate bone formation.