特立帕肽和双膦酸盐序贯治疗高龄骨质疏松症患者的疗效观察

Efficacy observation on sequential therapy with teriparatide and bisphosphonates for senile patients with osteoporosis

目的探讨特立帕肽和双膦酸盐序贯治疗高龄骨质疏松症患者的临床疗效及安全性。方法将72例高龄骨质疏松症患者随机分为对照组(唑来膦酸治疗)和研究组(特立帕肽与唑来膦酸序贯治疗),每组36例。比较2组患者治疗前后疼痛视觉模拟表评分法(VAS)评分、不同部位(腰椎、股骨颈及髋部)骨密度值、骨代谢指标[血钙、血磷、骨钙素(BGP)及碱性磷酸酶(ALP)]水平、不良反应及骨折发生率。结果治疗后,2组VAS评分均低于治疗前,且研究组VAS评分低于对照组,差异有统计学意义(P<0.05)。治疗后,2组腰椎、股骨颈及髋部骨密度值均高于治疗前,且研究组不同部位骨密度值均高于对照组,差异有统计学意义(P<0.05)。治疗后,对照组患者血钙、血磷水平均高于治疗前,差异有统计学意义(P<0.05),研究组血钙、血磷、BGP及ALP水平均高于治疗前,且研究组血磷、BGP水平高于对照组,差异有统计学意义(P<0.05)。2组不良反应发生率、骨折发生率比较,差异无统计学意义(P>0.05)。结论特立帕肽和双膦酸盐序贯治疗高龄骨质疏松症患者安全、有效,可缓解疼痛,提高骨密度值,改善骨代谢水平。

Objective To investigate the clinical efficacy and safety of sequential therapy with teriparatide and bisphosphonates for senile patients with osteoporosis.Methods Totally 72 senile patients with osteoporosis were randomly divided into control group(zoledronic acid)and study group(sequential therapy with teriparatide and zoledronic acid),with 36 cases in each group.Before and after treatment,the score of Visual Analogue Scale(VAS),the bone mineral density values of different parts(lumbar spine,femoral neck and hip),the levels of bone metabolism indexes[blood calcium,blood phosphorus,bone Gla-protein(BGP)and alkaline phosphatase(ALP)],adverse reactions and incidence rate of fracture were compared between the two groups.Results After treatment,the VAS scores in both groups were significantly lower than that before treatment(P<0.05),and the VAS score of the study group was significantly lower than that of the control group(P<0.05).After treatment,the bone mineral density values of lumbar spine,femoral neck and hip in both groups were significantly higher than those before treatment(P<0.05),and the bone mineral density values of different parts in the study group were significantly higher than those in the control group(P<0.05).After treatment,the levels of blood calcium and blood phosphorus in the control group were significantly higher than those before treatment(P<0.05),the levels of blood calcium,blood phosphorus,BGP and ALP in the study group were significantly higher than those before treatment(P<0.05),and the levels of blood phosphorus and BGP in the study group were significantly higher than those in the control group(P<0.05).There were no significant differences in the incidence rates of adverse reactions and fracture between the two groups(P>0.05).Conclusion Sequential therapy with teriparatide and bisphosphonate is effective and safe in treatment of senile patients with osteoporosis,which can relieve pain,increase bone mineral density and improve bone metabolism.