阿仑磷酸钠与骨化三醇治疗绝经后骨质疏松的临床效果

Clinical effect of alendronate combined with calcitriol in treatment of postmenopausal osteoporosis

目的:探讨阿仑磷酸钠联合骨化三醇治疗绝经后骨质疏松(POP)的临床效果。方法:选取某院收治的POP患者141例,按随机数字表法分为3组,每组47例。A组给予阿仑磷酸钠治疗,B组给予骨化三醇治疗,C组给予阿仑磷酸钠联合骨化三醇治疗。比较3组患者治疗效果、骨密度、血磷血钙浓度、骨代谢水平〔抗酒石酸酸性磷酸酶5b(TRACP5b)、骨型碱性磷酸酶(BALP)〕、疼痛程度及安全性。结果:C组治疗总有效率为95.74%,均高于A组和B组的78.72%、80.85%,差异有统计学意义(P<0.05);治疗前,3组骨密度值、血磷血钙浓度、骨代谢水平及疼痛程度比较,差异无统计学意义(P>0.05)。治疗后,C组患者股骨颈、化石三角区、腰椎正位及股骨粗隆部位骨密度值分别为(0.81±0.12)g/cm^(2)、(0.69±0.13)g/cm^(2)、(0.76±0.22)g/cm^(2)、(0.87±0.12)g/cm^(2),血磷血钙浓度为(2.30±0.20)mmol/L、(2.85±0.21)mmol/L,均高于A组和B组,差异有统计学意义(P<0.05),C组患者TRACP5b、BALP水平分别为(3.10±0.77)U/L、(24.26±6.32)U/L,视觉模拟评分法(VAS)评分为(2.51±0.35)分,均低于A组和B组,差异有统计学意义(P值均<0.05);3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:阿仑磷酸钠联合骨化三醇治疗POP患者临床效果较单一采用阿仑磷酸钠或骨化三醇更优,可有效提高骨密度值及骨代谢水平,增加血磷血钙浓度,缓解疼痛,且具有较高安全性,值得临床推广应用。

Objective:To explore the clinical effect of alendronate combined with calcitriol in treatment of postmenopausal osteoporosis(POP).Methods:141patients with POP admitted in a hospital were selected and randomly divided in 3 groups,with 47 cases in each.Group A was treated with alendronate,Group B with calcitriol and Group C with alendronate combined with calcitriol.The 3 groups were compared in terms of treatment effect,bone mineral density,concentrations of serum calcium and phosphorus,bone metabolic levels(TRACP5b,BALP),pain degree as well as safety.Results:The total effective rate of Group C was 95.74%,higher than Group A's 78.72%and Group B's 80.85%(P<0.05).Before treatment,there was no statistical differences between the 3 groups in terms of bone mineral density,concentrations of calcium and phosphorus,bone metabolic levels or pain degree(P>0.05).After treatment,the bone mineral densities of Groups C's patients in sections of collum femoris,fossil trigonum,anterial position of lumbar spine,and trochanter of femur were(0.81±0.12)g/cm^(2),(0.69±0.13)g/cm^(2),(0.76±0.22)g/cm^(2),and(0.87±0.12)g/cm^(2) respectively,and concentrations of serum calcium and phosphorus were(2.30±0.20)mmol/L,and(2.85±0.21)mmol/L respectively,all higher than those in Group A and Group B(all P<0.05).Levels of TRACP5b and BALP in patients of Group C were respectively(3.10±0.77)U/L and(24.26±6.32)U/L,and visual analogy score(VAS)was(2.51±0.35),lower than those in Group A and Group C(all P<0.05).As regards the incidence of adverse reaction,there was no statistical difference among the 3 groups(P>0.05).Conclusion:Alendronate combined with calcitriol in treatment of POP is superior to alendronate or calcitriol alone,which can effectively improve the value of bone mineral density and bone metabolic level,increase the concentrations of serum calcium and phosphorus and alleviate pain of patients.It is of high safety and worthy of clinical application.