阿仑膦酸钠联合阿法骨化醇对绝经后骨质疏松症患者骨密度、骨代谢指标及细胞因子的影响

Effects of alendronate sodium combined with alfacalcidol on bone mineral density,bone metabolism and cytokines in postmenopausal osteoporosis patients

目的观察阿仑膦酸钠联合阿法骨化醇对绝经后骨质疏松症患者骨密度、骨代谢指标及细胞因子的影响。方法选择2016年1月-2018年6月湖南省衡阳市中心医院骨科收治的绝经后骨质疏松症患者100例,运用随机抽签法分为研究组和对照组各50例。2组均接受常规钙剂治疗,对照组给予阿法骨化醇治疗,研究组在对照组基础上联合阿仑膦酸钠治疗。比较2组临床疗效、治疗前后骨密度、骨代谢指标、细胞因子及不良反应。结果研究组总有效率为80.00%,高于对照组的60.00%(χ2=4.762,P=0.029)。治疗后,2组患者腰椎正位、股骨颈及股骨粗隆骨密度均高于治疗前(P <0.01),骨特异性碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶-5b(TRACP-5b)均低于治疗前(P <0.01),且研究组患者变化幅度大于对照组(P <0.01)。治疗后,2组患者基质金属蛋白酶-9 (MMP-9)、MMP-13/金属蛋白酶组织抑制因子1(TIMP-1)均高于治疗前(P <0.01),TIMP-1均低于治疗前(P <0.05),且研究组患者变化幅度大于对照组(P <0.05)。2组患者不良反应总发生率比较差异无统计学意义(χ2=0.210,P=0.646)。结论阿仑膦酸钠联合阿法骨化醇治疗绝经后骨质疏松症临床疗效好,可改善患者的骨密度、骨代谢指标及细胞因子水平,且药物治疗安全性高,值得临床推广应用。

Objective To observe effects of alendronate sodium combined with alfacalcidol on bone mineral density,cytokines and bone metabolism in postmenopausal osteoporosis patients.Methods 100 patients with postmenopausal osteoporosis admitted to the Department of Orthopedics,Hengyang Central Hospital,Hunan Province from January 2016 to June 2018 were selected,and they were randomly divided into study group and control group,50 cases in each group.Both groups received conventional calcium treatment,the control group was treated with alfacalcidol,and the study group was treated with alendronate sodium on the basis of the control group.The clinical efficacy,bone mineral density,bone metabolism indexes,cytokines and adverse reactions before and after treatment were compared between the two groups.Results The total effective rate of the study group(80.00%) was higher than the control group(60.00%)(χ~2= 4.762,P =0.029).After treatment,the density of the lumbar spine,the density of the femoral neck,and the density of the femoral tuberosity of the two groups were higher than those before treatment(P < 0.01),BALP and TRACP-5 b were lower than before treatment(P < 0.01),and the range of changes in the study group were greater than that of the control group(P < 0.01).After treatment,the levels of MMP-9,MMP-13/TIMP-1 in the two groups were higher than those before treatment(P <0.01),and TIMP-1 was lower than before treatment(P < 0.05),and the change of patients in the study group was greater than that of the control group(P < 0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(χ~2= 0.210,P = 0.646).Conclusion Alendronate sodium combined with alfacalcidol has a good clinical effect in the treatment of postmenopausal osteoporosis,which can improve the bone density,bone metabolism indexes and cytokine levels of patients,and the safety of drug treatment is high,worthy of clinical promotion application.