阿法骨化醇增加伊班膦酸钠治疗绝经后骨质疏松症的疗效

目的探索阿法骨化醇(alfacalcidol,ALF)在伊班膦酸钠(ibandronate,IBN)治疗绝经后骨质疏松症期间的作用。方法选取2015年7月至2017年6月在我院就诊的56例绝经后骨质疏松症患者作为研究对象,随机分为IBN组和IBN/ALF组;IBN组给予IBN治疗,IBN/ALF给予IBN联合ALF,治疗为期12个月。观察治疗前后两组女性骨密度及骨代谢指标的改变。结果与治疗前相比,3个月后两组骨转换指标均显著降低(P0.05)。IBN/ALF组血清1型前胶原氨基末端前肽(N-propeptide of type 1 collagen,P1NP)、抗酒石酸酸性磷酸酶-5b(tartrate-resistant acid phosphatase-5b,TRACP-5b)和尿I型胶原N末端交联(urinary type I collagen crosslinked amino terminal peptide,NTX)水平明显低于IBN组(P0.05)。IBN/ALF组6个月和IBN组12个月时腰椎(L_(1～4))骨密度(bone mineral density,BMD)均显著增加(P0.05)。12个月时IBN/ALF组(4.7%)的L-BMD显著高于IBN组(2.9%)。IBN/ALF组的全髋(H)-BMD从6个月开始显著增加,而IBN组的H-BMD改善不明显。IBN/ALF组(4.3%)的H-BMD在12个月时显著高于IBN组(2.7%)。结论 ALF有助于IBN治疗绝经后骨质疏松症的疗效。

Alfacalcidol increases the efficacy of ibandronate in the treatment of postmenopausal osteoporosis

Objective This study aimed to explore the role of Alfacalcidol (ALF) in the treatment of postmenopausal osteoporosis with ibandronate (IBN). Methods 56 patients with postmenopausal osteoporosis treated in our hospital from July 2015 to June 2017 were selected and randomly divided into IBN group and IBN/ALF group. IBN group was given IBN treatment, and IBN/ALF group was given IBN combined with ALF treatment for 12 months. The changes in bone mineral density and bone metabolism were observed before and after treatment. Results Compared with pre-treatment, bone turnover markers significantly decreased in both groups after 3 months (P<0.05). The levels of serum N-terminal propeptide of type-1 procollagen, tartrate-resistant acid phosphatase-5b, and urinary N-terminal telopeptide of type-I collagen were significantly lower in IBN/ALF group than those in IBN group at 12 months (P<0.05). Lumbar spine L1-4 BMD significantly increased from 6 months in IBN/ALF group and at 12 months in IBN group. L1-4 BMD had significantly greater increase in IBN/ALF group (6.6% increase) than in IBN group (3.4%) at 12 months. Total hip BMD significantly increased from 6 months in IBN/ALF group and had a non-significant trend of improvement in IBN group. Hip BMD had significantly greater increase in IBN/ALF group (4.8%) than in IBN group (3.2%) at 12 months. Conclusion Treatment with ALF in combination with IBN improved BMD in post-menopausal women with osteoporosis.