唑来膦酸注射对绝经后骨质疏松患者骨钙素及骨特异性碱性磷酸酶水平的影响

Effects of zoledronic acid injection on levels of bone glaprotein and bone-specific alkaline phosphatase in postmenopausal patients with osteoporosis

目的初步观察阿仑膦酸钠与唑来膦酸治疗绝经后骨质疏松患者的疗效及对血清骨特异性碱性磷酸酶(BALP)、骨钙素(BGP)水平的影响。方法选择某院于2019年9月~2020年9月期间住院及门诊治疗的绝经后骨质疏松患者76例作为研究对象,采用随机数表法分为观察组及对照组,每组各38例。两组患者在碳酸钙D_(3)片及阿法骨化醇软胶囊基础治疗的同时,对照组患者予以阿仑膦酸钠片口服治疗,观察组患者予以唑来膦酸静脉注射治疗。观察治疗前后两组患者BALP与BGP水平,骨密度(BMD)以及临床治疗效果。结果治疗前两组患者血清BALP与BGP水平、右股骨颈以及腰椎正位(L_(2~4))BMD水平的比较差异无统计学意义(P>0.05),治疗12个月后观察组患者BALP与BGP水平较对照组显著降低,而BMD水平明显升高(P>0.05)。视觉模拟评分法(VAS)评估显示对照组临床治疗的总优良率为84.21%,观察组为97.37%,差异具有统计学意义(P<0.05)。结论唑来膦酸较阿仑膦酸钠治疗绝经后骨质疏松的临床疗效更为显著,增加患者骨密度,并进一步下调BALP与BGP水平。

Objective To observe the effect of alendronate sodium and zoledronic acid on serum bone specific alkaline phosphatase(BALP)and bone glaprotein(BGP)levels in postmenopausal osteoporosis.Methods 76 patients with postmenopausal osteoporosis in our hospital from September 2019 to September 2020 were selected as the study subjects,and were divided into observation group and control group by random number table method,with 38 cases in each group.Patients in the two groups were treated with calcium carbonate D_(3) tablets and alfacalcitriol soft capsule,while patients in the control group were treated with alendronate sodium tablets orally,and patients in the observation group were treated with zoledronic acid intravenous.BALP and BGP levels,bone mineral density(BMD)and clinical treatment effect were observed before and after treatment.Results There were no significant differences in serum BALP and BGP levels,BMD levels in right femoral neck and lumbar spine(L_(2~4))before treatment(P>0.05).After 12 months of treatment,BALP and BGP levels in observation group were significantly lower than those in control group,while BMD levels were significantly higher(P<0.05).Visual analogue scale(VAS)showed that the total excellent and good rate of treatment was 84.21%in the control group and 97.37%in the observation group,and the difference was statistically significant(P<0.05).Conclusion Zoledronic acid is more effective than alendronate sodium in the treatment of postmenopausal osteoporosis,increasing bone mineral density,and further down-regulating BALP and BGP levels.