特立帕肽持续用药时间对老年女性骨质疏松症患者疗效的影响

Impact of medication duration of teriparatide on the curative efficacy in elderly women with osteoporosis

目的探讨特立帕肽持续用药时间对老年女性骨质疏松症(OP)患者疗效的影响。方法回顾性分析浙江省人民医院望江山院区2013年1月至2020年12月收治的54例接受过特立帕肽治疗的老年女性OP患者的临床资料。根据接受特立帕肽持续使用时间分为2组,其中≥6个月24例(观察组),<6个月30例(对照组)。比较2组特立帕肽用药前和首次用药后6个月的血清骨转换标志物水平和骨密度。结果治疗前,2组血清总Ⅰ型胶原氨基端前肽、N端骨钙素和Ⅰ型胶原羧基端肽β特殊序列水平,股骨颈、总髋部和腰椎骨密度(LSBMD)比较差异均无统计学意义(均P>0.05);治疗6个月后,观察组血清总Ⅰ型胶原氨基端前肽、N端骨钙素、Ⅰ型胶原羧基端肽β特殊序列水平和LSBMD均高于对照组[(83±24)μg/L比(65±18)μg/L,(28.9±4.7)μg/L比(22.1±2.4)μg/L,(0.45±0.16)μg/L比(0.32±0.13)μg/L,(1.03±0.18)g/cm;比(0.98±0.19)g/cm;](均P<0.05)。结论特立帕肽持续使用时间≥6个月患者血清骨转换标志物水平和LSBMD明显升高;在不超过总疗程的前提下,延长特立帕肽持续使用时间可能有助于提高老年女性OP患者的临床疗效。

Objective To investigate the impact of medication duration of teriparatide on the curative efficacy in elderly women with osteoporosis(OP). Methods Clinical data of 54 elderly OP women treated with teriparatide in Wangjiangshan Branch of Zhejiang Provincial People′s Hospital from January 2013 to December 2020 were retrospectively analyzed. The patients were divided into two groups according to the duration of teriparatide treatment, including 24 patients with treatment ≥6 months(observation group) and 30 patients with treatment <6 months(control group). Serum levels of bone turnover markers and bone mineral densities were compared between two groups before and 6 months after the first administration of teriparatide. Results There were no significant differences in serum levels of total procollagen type Ⅰ amino-terminal propeptide(PⅠNP), N-mid fragment of osteocalcin, carboxy-terminal telopeptide of type Ⅰ collagen(CTX), femoral neck bone mineral density, total hip bone mineral density, and lumbar spine bone mineral density(LSBMD) between two groups before treatment(all P>0.05). Six months after treatment, the serum levels of PⅠNP, N-mid fragment of osteocalcin, CTX and LSBMD in observation group were higher than those in control group [(83±24)μg/L vs(65±18)μg/L,(28.9±4.7)μg/L vs(22.1±2.4)μg/L,(0.45±0.16)μg/L vs(0.32±0.13)μg/L,(1.03±0.18)g/cm;vs(0.98±0.19)g/cm;](all P<0.05). Conclusions The levels of serum bone turnover markers and LSBMD significantly increase in patients receiving teriparatide treatment ≥6 months. Prolonging the duration of teriparatide treatment may contribute to improve the clinical efficacy on anti-osteoporosis in elderly OP women under the premise within the total course of treatment.