邦得林治疗雄性骨质疏松大鼠的实验研究

目的：探讨邦得林（羟乙膦酸钠）对男性骨质疏松内代的影响。方法：采用15周龄雄性大鼠去睾后作为动物模型,随机分为3组：正常对照组、去势组、邦得淋治疗组,28周后行血尿生化、骨密度、骨生物力学及病理检查。结果：与正常组比较,模型组睾酮水平明显下降（P＜0.01）,全身及股骨中点骨密度明显下降（P＜0.05）,碱性磷酸酶显著降低（P＜0.01）,24h尿羟脯氨酸、尿钙与肌苷比显著增高（P＜0.05）,股骨最大受力负荷及股骨最大挠度均显著下降（P＜0.05）,骨小梁体积、骨表面面积／体积、平均骨小梁厚度显著下降（P＜0.01）;邦得林治疗组大鼠全身与股骨骨密度显著下降（P＜0.05）,弹性模量显著增加（P＜0.05）,24h尿羟脯氨酸、尿钙与肌苷比值已降低到正常组大鼠水平,骨小梁体积、平均骨小梁厚度、平均骨小梁板间隙明显上升（P＜0.01),平均骨小梁板密度明显下降（P＜0.01）。结论：去势使大鼠骨形成减慢,骨吸收加速,造成了男性骨质疏松的动物模型。早期应用邦得林可缓解雄激素缺乏引起的骨吸收加速,但仍不能完全预防骨质疏松的发生。     

Cyclical Etidronate Therapy for Prevention of Postmenopausal Bone Loss: A 1-Year Open-Label Follow-Up Study

The objective of this study was to evaluate whether the pharmacological activity of cyclical etidronate therapy is sustained beyond the dosing period. A group of 121 postmenopausal women who had completed a 2-year, double-blind, placebo-controlled parallel study with etidronate or placebo (400 mg/day for 14 days every 3 months) and calcium agreed to participate in a 1-year open-label follow-up study to evaluate the effect of discontinuing etidronate treatment. Fifty-nine subjects in the former etidronate group and 62 in the placebo group received 500 mg/day of elemental calcium; 54/59 and 58/62 subjects, respectively, completed the study. Outcomes of the study were bone mineral density (BMD), measured by dual energy X-ray absorptiometry (DXA), and biochemical markers of bone turnover (urinary deoxypyridinoline/creatinine and serum osteocalcin). To determine whether there was a residual effect of previous therapy we compared mean percentage changes from baseline (year 0) to year 3 for both spinal and femoral neck BMD and markers of bone turnover in the former cyclical etidronate and placebo groups. To evaluate the carryover effect of treatment we compared the percent change from year 2 to year 3 for the same variables. Mean percentage change (SEM) from year 2 to year 3 for spinal BMD in the former cyclical etidronate group was −2.87% (0.48%) versus −0.99% (0.36%) in the placebo group (P= 0.0022). In the femoral neck, the BMD changes were −0.86% (0.42%) versus −1.01% (0.41%) (NS). Biochemical markers increased within 6 months toward baseline levels. Mean percentage changes from baseline (year 0) in both spinal and femoral neck BMD were significantly different between groups 1 year after treatment discontinuation. No differences between groups were maintained in deoxypyridinoline and osteocalcin. It is concluded that following withdrawal of cyclical etidronate therapy bone loss resumes at a normal and moderately accelerated rate in the proximal femur and lumbar spine, respectively. A positive effect on BMD at both cortical and trabecular sites is maintained for 1 year after treatment withdrawal. Received: 8 May 1999 / Accepted: 10 December 1999     

Clinical and haematological improvement induced by etidronate in a patient with idiopathic myelofibrosis and osteosclerosis

Summary We report a patient with agnogenic myeloid metaplasia associated with debilitating bone pain due to increased bone turnover and osteosclerosis. Treatment with etidronate at a dose of 6 mg/kg per day on alternate months resulted in a complete recovery of bone symptoms and normalization of metabolic parameters of bone turnover; unexpectedly, a sustained haematological improvement was also observed after several months of therapy, suggesting that bone marrow microenvironment improvement was able to restore a nearly normal haemopoiesis. We suggest that diphosphonate therapy may be of value in patients with AMM and increased bone turnover.     

Cyclical etidronate increases bone density in the spine and hip of postmenopausal women receiving long term corticosteroid treatment. A double blind, randomised placebo controlled study

OBJECTIVE: To study the effect of cyclic etidronate in secondary prevention of corticosteroid induced osteoporosis. METHODS: A double blind, randomised placebo controlled study comparing cyclic etidronate and placebo during two years in 37 postmenopausal women receiving long term corticosteroid treatment, mainly for polymyalgia rheumatica (40% of the patients) and rheumatoid arthritis (30%). Bone density was measured in the lumbar spine, femoral neck, and femoral trochanter. RESULTS: After two years of treatment there was a significant difference between the groups in mean per cent change from baseline in bone density in the spine in favour of etidronate (p = 0.003). The estimated treatment difference (mean (SD)) was 9.3 (2.1)%. Etidronate increased bone density in the spine (4.9 (2.1)%, p < 0.05) whereas the placebo group lost bone (-2.4 (1.6)%). At the femoral neck there was an estimated difference of 5.3 (2.6)% between the groups (etidronate: 3.6% (1.4)%, p < 0.05, placebo: -2.4 (2.1)%). The estimated difference at the trochanter was 8.2 (3.0) (etidronate: 9.0 (1.5)%, p < 0.0001, placebo: 0.5 (2.3)%). No significant bone loss occurred in the hip in placebo treated patients. CONCLUSIONS: Cyclic etidronate is an effective treatment for postmenopausal women receiving corticosteroid treatment and is well tolerated.     

pH滴定法测定羟乙膦酸钠的含量

本文采用ｐＨ滴定法,以ｐＨ５．０为起始ｐＨ,ｐＨ８．２为终点指示ｐＨ,用ＮａＯＨ直接滴定,测定了羟乙膦酸钠的含量。该方法简便、准确快速,平均回收率为１００．７２％,ＲＳＤ为０．２２％（ｎ＝６）。     

Low-dose oral etidronate therapy for immobilization hypercalcaemia associated with Guillain-Barré syndrome

A low dose of oral etidronate (3.7 mg kg(-1) d(-1)) was administered for immobilization hypercalcaemia associated with Guillain-Barré syndrome in a 12-y-old boy. There was a slight increase in osteoblastic bone formation reflected by alkaline phosphatase and in particular bone-specific alkaline phosphatase during the treatment and serum calcium decreased to the normal range within 2 wk. No adverse side effects were observed and the patient's linear growth subsequently progressed. CONCLUSION: A low dose of oral etidronate is safe and effective for treatment of immobilization hypercalcaemia in children, without inhibiting bone formation.     

Pulmonary alveolar microlithiasis in childhood: clinical and radiological follow-up

This report describes a case of pulmonary alveolar microlithiasis that was diagnosed in an 8.5-year-old girl by high-resolution computed tomography (CT) and open lung biopsy. Presence of symptoms (productive cough, fever), their periodic occurrence (lasting up to 1 week), and comparatively long asymptomatic periods should be emphasized. Despite extensive X-ray abnormalities, tests of pulmonary interstitium involvement and exercise tests revealed normal results. A therapeutic regimen, including disodium etidronate, was administered for 18 months with no significant clinical or radiological improvement.     

荧光淬灭法测定羟乙磷酸二钠的含量

建立了荧光淬灭法测定羟乙磷酸二钠（ＥＨＤＰ）的含量，激发波长４００ｎｍ，检测波长５００ｎｍ。大本实验条件下线性范围０．３～０．８ｍｇ／Ｌ，ｒ＝－０．９９９２，回收率９８．７６％～１００．５％，（ｎ＝６），ＲＳＤ小于１．３６％，日内和日间ＲＳＤ分别为０．６４％和２．５７％。     

衍生化紫外分光光度法测定依替膦酸二钠片的溶出度

目的建立测定依替膦酸二钠片溶出度的方法。方法采用转篮法,以水900mL为溶出介质,于续滤液中加0．07％硫酸铜溶液,用紫外分光光度法测定,波长为233nm。结果依替膦酸二钠在浓度16．5～55．0μg·mL^-1内线性关系良好（r=0．9995）,平均回收率为101．1％,RSD为0．8％（n=9）,30min时平均溶出量大于90％。结论本法准确,简便,可用于测定依替膦酸二钠片的溶出度。