阿仑膦酸钠联合钙尔奇D与钙尔奇D单药治疗对老年女性糖尿病骨质疏松疗效的观察

目的观察阿仑膦酸钠(ALN)联合钙尔奇D与钙尔奇D单药治疗老年女性糖尿病骨质疏松症的骨密度变化以及ALN的安全性。方法老年女性2型糖尿病(T2DM)骨质疏松患者72例,随机分为:ALN联合钙尔奇D组37例,给予ALN(70mg/w)和钙尔奇D(600mg/d);钙尔奇D组35例(600mg/d)总疗程6个月。采用双能X线骨密度测量仪(DXA)测定治疗前后腰椎及髋部骨密度。结果钙尔奇D组治疗前后腰椎及髋部骨密度各部位均有增加,但仅在L1及L4部位T值治疗前后有统计学差异(P0.05);ALN联合钙尔奇D治疗组,腰椎和髋部骨密度均有增加,尤其在腰椎的L1、L3、L4及L总部位均有统计学意义(P0.05)。ALN主要不良反应为上腹部不适,钙尔奇D则以便秘为主。结论ALN联合钙尔奇D治疗可以明显提高老年女性糖尿病骨质疏松患者的骨密度,并具有良好的耐受性和安全性。

Therapeutic effect of alendronate plus caltrate or caltrate alone in type 2 diabetic elderly women with osteoporosis

Objective To compare changes in bone mineral density (BMD) during 6 months of alendronate (ALN) plus Caltrate treatment versus Caltrate alone in diabetic elderly women with osteoporosis and the safety/tolerability of ALN.Methods 72 of T2DM elderly women with osteoporosis were randomly assigned to either ALN plus Caltrate group(37 cases)or Caltrate group (35 cases):for 6 months 70 mg/week ALN and 600 mg/day Caltrate.BMD at the lumbar spine and hip was measured by dual-energy X-ray absorptiometry (DEXA) before and after the treatment.Results In Caltrate group BMD at more sites of lumbar spine and hip was slightly increased,but only in lumbar spine of L_1 and L_4 T values are significantly different (P＜ 0.05).ALN plus Caltrate group,BMD at the lumbar spine and hip was increased,especially in the lumbar spine BMD of L_1,L_3,L_4 and L total parts was statistically significant (P＜0.05).The main adverse reactions:upper abdominal discomfort of ALN and constipation of Caltrate are based.Conclusions ALN plus Caltrate increase BMD significantly relative to Caltrate in diabetic elderly women with osteoporosis.And it is safe and generally well,tolerated as a treatment for osteoporosis.