阿仑膦酸钠联合钙尔奇D对比单用钙尔奇D在慢性阻塞性肺疾病合并骨质疏松症患者中的疗效观察

Observation on the efficacy of alendronate sodium combined with Caltrate D compared to that of Caltrate D alone in patients with chronic obstructive pulmonary disease and osteoporosis

目的比较阿仑膦酸钠联合钙尔奇D与单用钙尔奇D在慢性阻塞性肺疾病(COPD)合并骨质疏松症患者中的疗效。方法将2019年12月至2022年5月贵港市人民医院呼吸与危重症医学科住院或门诊确诊为COPD合并骨质疏松症的患者按随机数表法分为试验组(n=50)和对照组(n=50)。试验组给予阿仑膦酸钠+钙尔奇D治疗,对照组给予钙尔奇D治疗。通过比较治疗前后肺功能、骨密度、骨代谢生化指标、体重指数(BMI)、COPD评估测试问卷(CAT)评分、6分钟步行距离(6MWD)指标来评价两组疗效。结果治疗前后,两组BMI、钙、磷、镁、血清骨源性碱性磷酸酶(BAP)比较,差异无统计学意义(P>0.05)。治疗后,两组第1秒用力呼气量(FEV1)、FEV1占预计值的百分比(FEV1%pred)、FEV1占用力肺活量的比值(FEV1/FVC)、6MWD均较治疗前有显著改善,差异有统计学意义(P<0.05),但治疗后两组上述指标比较,差异无统计学意义(P>0.05)。试验组CAT评分、血清抗酒石酸酸性磷酸酶-5b(TRACP-5b)、腰椎和股骨的骨密度值较对照组明显改善,差异有统计学意义(P<0.05)。结论阿仑膦酸钠+钙尔奇D较单用钙尔奇D在COPD合并骨质疏松症患者的主观感受、骨密度值及骨代谢生化指标检测上均有改善。

Objective To compare the efficacy of alendronate sodium combined with Caltrate D and Caltrate D alone in patients with chronic obstructive pulmonary disease(COPD)and osteoporosis.Methods Patients diagnosed with COPD and osteoporosis in the Department of Respiratory and Critical Care Medicine of Guigang City People’s Hospital as inpatients or outpatients from December 2019 to May 2022 were randomly divided into a test group(n=50)and a control group(n=50)according to the random number table method.The experimental group was given alendronate sodium+Caltrate D,and the control group was given Caltrate D.The efficacy of the two groups was evaluated before and after treatment by comparing lung function,bone density,bone metabolism biochemical indicators,body mass index(BMI),COPD assessment scale(CAT)score,six minute walk distance(6MWD).Results The BMI,calcium,phosphorus,magnesium,and serum bone alkaline phosphatase(BAP)levels before and after treatment were compared between the two groups,without statistically significant differences(P>0.05).The forced expiratory volume in the first second(FEV1),percentage of the forced expiratory volume in the first second to predicted value(FEV1%pred),ratio of the forced expiratory volume in the first second to forced vital capacity(FEV1/FVC),and 6MWD of the test and control groups were significantly improved compared to those before,,with statistically significant differences(P<0.05).However,the results after treatment were compared between the two groups,without statistically significant difference(P>0.05).The CAT score,tartrate resistant acid phosphatase-5b(TRACP-5b),and bone density values of the lumbar spine and femur in the test group were significantly improved compared to those in the control group,with statistically significant differences(P<0.05).Conclusion Alendronate sodium+Caltrate D improves subjective perception,bone density values,and bone metabolism biochemical indicators in patients with COPD and osteoporosis compared to Caltrate D alone.