地舒单抗联合雷洛昔芬对绝经后骨质疏松患者性激素结合球蛋白骨硬化蛋白水平的影响

Effect of desumab combined with raloxifene on SHBG and SOST in postmenopausal osteoporosis patients

目的分析地舒单抗联合雷洛昔芬对绝经后骨质疏松患者性激素结合球蛋白(SHBG)、骨硬化蛋白(SOST)水平的影响。方法选取浙江省金华市中心医院2022年6月至2023年6月就诊的绝经后骨质疏松患者140例,按照随机数字表法分成研究组和对照组,各70例。分析2组的性激素水平、骨强度结果、氧化应激、SHBG、SOST、骨代谢标志物水平及临床疗效。结果治疗后2组患者雌二醇(E_(2))、促卵泡激素(FSH)、促黄体生成素(LH)、骨密度、骨矿含量、超氧化物歧化酶(SOD)、谷胱甘肽(GSH)表达水平均高于治疗前,且研究组治疗后的E2、FSH、LH、骨密度、骨矿含量、SOD、GSH均高于对照组(t=4.524,3.524,4.534,3.254,3.563,6.524,7.845;P<0.05)。2组患者治疗后的丙二醛(MDA)、SHBG、SOST、Ⅰ型胶原交联氨基端肽(NTX1)、Ⅰ型胶原交联羧基端肽(CTX1)、抗酒石酸酸性磷酸酶5b(TRACP5b)、骨钙素(BGP)表达水平均低于治疗前(P>0.05);且研究组治疗后的MDA、SHBG、SOST、NTX1、CTX1、TRACP5b、BGP水平均低于对照组(t=3.893,3.895,3.853,4.325,19.532,4.054,3.956;P<0.05)。研究组治疗后有效率高于对照组(χ^(2)=4.516,P<0.05)。2组治疗后的不良反应率差异无统计学意义(χ^(2)=0.110,P=-0.740)。结论地舒单抗、雷洛昔芬联合使用,可使绝经后骨质疏松患者骨代谢水平、氧化应激反应得到改善,并提高患者性激素水平,降低SHBG、SOST表达,促使患者恢复。

Objective To analyze the effect of deshuzumab combined with raloxifene on the levels of sex hormone binding globulin(SHBG)and Sclerosteosis(SOST)in postmenopausal osteoporosis patients.Methods A total of 140 postmenopausal osteoporosis patients diagnosed in Jinhua Central Hospital hospital from June 2022 to June 2023 were randomly divided into a study group and a control group,with 70 cases in each group.Analyze the levels of sex hormones,bone strength results,oxidative stress,SHBG,SOST,bone metabolism markers,and clinical efficacy of two groups.Results After treatment,the expression levels of estradiol(E_(2)),follicle stimulating hormone(FSH),luteinizing hormone(LH),bone density,bone mineral content,superoxide dismutase(SOD),and glutathione(GSH)in both groups of patients were higher than those before the treatment.The expression levels of E2,FSH,LH,bone density,bone mineral content,SOD,and GSH in the study group were higher than those in the control group after the treatment(t=4.524,3.524,4.534,3.254,3.563,6.524,7.845,P<0.05).The expression lev-els of malondialdehyde(MDA),SHBG,SOST,N-telopeptide of type I collagen(NTX1),C-terminal telopeptides of type I collagen(CTX1),tartrate resistant acid phosphatase 5b(TRACP5b),and osteocalcin(BGP)in two groups of patients after treatment were lower than those before the treatment(P>0.05).The levels of MDA,SHBG,SOST,NTX1,CTX1,TRACP5b,and BGP in the study group after the treatment were lower than those in the control group(t=3.893,3.895,3.853,4.325,19.532,4.054,3.956,P<0.05).The effective rate of the study group after the treatment was significantly higher than that of the control group(χ^(2)=4.516,P<0.05).There was no statistically sig-nificant difference in the incidence of adverse reactions between the two groups after treatment(χ^(2)=0.110,P=0.740).Conclusion Combined use of desomumab and raloxifene can improve bone metabolism and oxidative stress response in postmenopausal osteoporosis patients,and improve the level of sex hormones,reduce the ex-pression of SHBG and SOST,and promote the recovery of patients.