酪酸梭菌联合阿仑膦酸钠治疗骨质疏松症的疗效及对患者血清骨代谢指标、Th1细胞因子水平的影响

Efficacy of Clostridium butyricum combined with alendronate sodium in the treatment of osteoporosis and effects on serum bone metabolism indicators and Th1 cytokines levels of patients

目的探讨酪酸梭菌联合阿仑膦酸钠对骨质疏松症患者的疗效及骨代谢指标、Th1细胞因子水平的影响。方法选择2019年3月至2021年9月就诊于咸阳市第一人民医院的骨质疏松症患者114例,采用简单随机法分为研究组和对照组各57例。对照组患者给予阿仑膦酸钠治疗,研究组患者除服用阿仑膦酸钠外,同时给予酪酸梭菌活菌片治疗,两组患者均持续治疗3个月。两组患者均于用药前、用药3个月时检测并比较股骨颈骨密度、血清骨代谢指标[血清总骨Ⅰ型胶原氨基端延长肽(PⅠNP)、骨钙素(BGP)、血清Ⅰ型胶原羧基末端交联肽(β-CTX)、血清骨碱性磷酸酶(BALP)及β-胶原特殊序列(β-crossl)]及Th1细胞因子[白细胞介素2(IL-2)、γ干扰素(IFN-γ)]水平。结果治疗3个月后,两组患者的股骨颈骨密度明显高于治疗前,且研究组为(0.815±0.047)g/cm^(2),明显高于对照组的(0.791±0.036)g/cm^(2),差异均有统计学意义(P<0.05);两组患者治疗3个月后,PINP、BGP、β-CTX、β-crossl及血清IFN-γ水平较治疗前明显降低,且研究组分别为(22.98±7.01)ng/mL、(2.98±0.74)ng/mL、(0.26±0.04)ng/mL、(156.15±24.12)ng/L,明显低于对照组的(28.03±8.96)ng/mL、(4.57±1.02)ng/mL、(0.33±0.06)ng/mL、(195.61±23.39)ng/L,差异均有统计学意义(P<0.05);治疗3个月后,两组患者的BALP、血清IL-2水平较治疗前明显上升,且研究组分别为(62.95±4.16)ng/mL、(196.41±36.22)ng/L,明显高于对照组的(51.08±5.13)ng/mL、(173.75±35.49)ng/L,差异均有统计学意义(P<0.05);治疗过程中,研究组患者的总不良反应发生率为7.0%,略高于对照组的3.5%,但差异无统计学意义(P>0.05)。结论酪酸梭菌活菌片联合阿仑膦酸钠治疗骨质疏松症可增加患者骨密度,改善血清骨代谢状态及Th1细胞因子水平,具有良好的临床治疗效果。

Objective To explore the efficacy of Clostridium butyricum combined with alendronate sodium in the treatment of patients with osteoporosis and the effects on bone metabolism indicators and Th1 cytokines levels.Methods A total of 114 patients with osteoporosis treated in the First People's Hospital of Xianyang were selected between March 2019 and September 2021.They were divided into a study group and a control group by the simple randomization,with 57 patients in each group.Patients in the control group were treated with alendronate sodium,while patients in the study group were given Clostridium butyricum tablets in addition to alendronate sodium,continuously for 3 months.The levels of bone mineral density of femoral neck,serum bone metabolism indicators[serum procollagen typeⅠN-terminal propeptide(PⅠNP),bone gla protein(BGP),serum βcross-linked C-telopeptide of type 1 collagen(β-CTX),serum bone alkaline phosphatase(BALP),and β-collagen specific sequence(β-crossl)]and Th1 cytokines[interleukin 2(IL-2),γinterferon(IFN-γ)]before medication and after 3 months of medication were detected and compared between the two groups.Results After 3 months of treatment,the bone mineral density of femoral neck of the two groups was significantly higher than that before treatment;and the density was(0.815±0.047)g/cm^(2) in the study group,significantly higher than(0.791±0.036)g/cm^(2) in the control group(P<0.05).After 3 months of treatment,the levels of PINP,BGP,β-CTX,β-crossl and serum IFN-γin the two groups were significantly reduced compared with before treatment,and the above indexes in the study group were(22.98±7.01)ng/mL,(2.98±0.74)ng/mL,(0.26±0.04)ng/mL and(156.15±24.12)ng/L,respectively,significantly lower than(28.03±8.96)ng/mL,(4.57±1.02)ng/mL,(0.33±0.06)ng/mL and(195.61±23.39)ng/L in the control group(P<0.05).The levels of BALP and serum IL-2 in the two groups after 3 months of treatment were significantly increased compared with those before treatment,and the above indexes levels in the study group were(62.95±4.16)ng/mL and(196.41±36.22)ng/L,significantly higher than(51.08±5.13)ng/mL and(173.75±35.49)ng/L in the control group(P<0.05).During the treatment,the total incidence of adverse reactions in the study group was 7.0%,which was slightly higher than 3.5%in the control group,but the difference was not statistically significant(P>0.05).Conclusion Clostridium butyricum tablets combined with alendronate sodium can increase the bone mineral density,and improve the serum bone metabolism status and Th1 cytokines levels,and it has a good therapeutic effect on patients with osteoporosis.