运动疗法对绝经后骨质疏松症骨转换及炎性因子的影响

Effect of Exercise Therapy on Bone Turnover and Inflammatory Factors in Postmenopausal Osteoporosis

目的观察运动疗法在常规抗骨质疏松药物治疗基础上对绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)骨转换、炎性因子水平的影响及相关性分析。方法筛选符合纳入标准的绝经后骨质疏松症患者72例,随机分为观察组和对照组。观察组36例,年龄52~59岁,平均(56.03±2.86)岁;对照组36例,年龄50~58岁,平均(55.36±2.88)岁。对照组予以常规抗骨质疏松药物(钙剂、膦酸盐类)治疗,观察组在对照组的基础上予以有氧运动和递增式抗阻训练的组合式运动疗法。分别于治疗前和治疗3个月后检测患者L 1~4骨密度(bone mineral density,BMD)、左侧股骨颈BMD、血清Ⅰ型原胶原N-端前肽(serum N-terminal peptide of typeⅠcollagen,S-PINP)、血清Ⅰ型胶原C-末端肽交联(serum C-terminal telopeptide of typeⅠcollagen,S-CTX)、白细胞介素(interleukin,IL)-6、肿瘤坏死因子(tumour necrosis factor,TNF)-α水平并进行统计分析。结果两组患者的L 1~4 BMD、左侧股骨颈BMD均较治疗前增高,且观察组显著高于对照组(P<0.05);两组患者骨转换生化指标(bone turnover marker,BTM)中的S-PINP、S-CTX均较治疗前降低,且观察组显著低于对照组(P<0.05);两组患者炎性指标IL-6、TNF-α水平均较治疗前降低,且观察组显著低于对照组(P<0.05)。结论运动疗法联合治疗可以有效增加PMOP患者骨密度,降低骨转换水平,抑制炎性因子,进而促进骨重塑的正性平衡,有利于PMOP的防治。

Objective To observe the effect of exercise therapy on bone turnover and inflammatory factor level in postmenopausal osteoporosis(PMOP)on the basis of conventional anti osteoporosis drug therapy and analyze the correlation.Methods 72 postmenopausal osteoporosis patients who met the inclusion criteria were selected and randomly divided into an observation group and a control group.The observation group consisted of 36 cases,ranging in age from 52 to 59 years old,with an average age of(56.03±2.86)years.The control group consisted of 36 cases,ranging in age from 50 to 58 years old,with an average age of(55.36±2.88)years.The control group was treated with conventional anti osteoporosis drugs(calcium and phosphonates),while the observation group received a combination of aerobic exercise and incremental resistance training on the basis of the control group.Bone mineral density(BMD)of L 1~4,left neck of femur BMD,serum N-terminal peptide of type I collagen(S-PINP),serum C-terminal peptide of type I collagen(S-CTX),interleukin(IL)-6,tumor necrosis factor(TNF)-αLevel were measured before treatment and 3 months after treatment respectively.Results The L 1~4 BMD and left neck of femur BMD of the two groups were higher than those before treatment,and the BMD of the observation group was significantly higher than that of the control group(P<0.05).The biochemical indicators of bone turnover marker(BTM)S-PINP and S-CTX in both groups of patients decreased compared with those before treatment,and the observation group was significantly lower than the control group(P<0.05).Inflammatory markers IL-6 and TNF-αin two groups of patients decreased compared to those before treatment,and the observation group was significantly lower than the control group(P<0.05).Conclusion Combined exercise therapy can effectively increase BMD of PMOP patients,reduce bone turnover,inhibit inflammatory factors,and then promote the positive balance of bone remodeling,which is conducive to the prevention and treatment of PMOP.