维生素K2与地舒单抗联合治疗女性绝经后骨质疏松疗效分析

On Combination of Vitamin K2 and Denosumab in Postmenopausal Osteoporosis in Women

目的探讨单独应用维生素K2(VK2)、地舒单抗(Denosumab)与两种药物联合应用治疗女性绝经后骨质疏松(Postmenopausal Osteoporosis,PMOP)的临床疗效.方法将60例绝经后PMOP患者分为VK2组、Denosumab组及联合组,每组20例,分别予以VK2、Denosumab及两种药物联合行抗PMOP治疗.治疗前及治疗后3、6、9、12个月分别监测腰椎及股骨颈骨密度(BMD)、骨钙素(BGP)、I型胶原C-末端肽(CTX)、抗酒石酸酸性磷酸酶(TRACP)等指标.结果治疗后,3组患者腰椎及股骨颈BMD均较治疗前增加(P<0.05),CTX和TRACP较治疗前下降(P<0.05);治疗后,VK2组各时间点BGP较治疗前升高(P<0.05),Denosumab组和联合组各时间点BGP较治疗前降低(P<0.05);治疗后,相同时间点联合组腰椎及股骨颈BMD高于VK2组和Denosumab组(P<0.05),联合组CTX和TRACP高于VK2组和Denosumab组(P<0.05),联合组BGP高于Denosumab组、低于VK2组.结论与单药治疗比较,联合使用Denosumab与VK2治疗女性绝经后骨质疏松临床疗效更佳,对骨转换标志物(BTMs)有显著影响.

ObjectiveTo explore the clinical efficacy of vitamin K2 and Denosumab alone and the combination of two drugs in the treatment of postmenopausal osteoporosis in women.Method60 PMOP patients were divided into VK2,Denosumab and combination groups,20 cases in each group,respectively VK2 and Denosumab and two drugs combination treatment PMOP.Before and after treatment for 3,6,9 and 12 months respectively,monitoring of lumbar spine and femoral neck bone mineral density(BMD),bone gla protein(BGP),type I collagen end C-peptide(CTX),tartrate resistant acid phosphatase(TRACP).ResultsAfter treatment,the lumbar and femoral neck BMD of patients in three groups increased than before treatment(P<0.05),and CTX and TRACP decreased(P<0.05).After treatment,BGP increased at each time point in VK2 group compared with before treatment(P<0.05),and BGP in Denosumab group and combination group decreased than before treatment(P<0.05).At the same time point,lumbar spine and femoral neck BMD in the combination group were higher than those in the VK2 group and Denosumab group(P<0.05),CTX and TRACP in the combination group were higher than those in VK2 group and Denosumab group(P<0.05),BGP in the combination group was higher than that of Denosumab group and lower than that of VK2 group.ConclusionCompared with monotherapy,the combination of Denosumab and VK2 had better postmenopausal osteoporosis,and had a significant effect on bone turnover markers(BTMs).