阿伦膦酸盐预防激素相关性骨量丢失的前瞻性研究

目的 研究阿伦膦酸盐预防激素相关性骨质疏松的作用.方法 将21例需要长期服用糖皮质激素的风湿病患者随机分为治疗组和对照组.对照组在应用糖皮质激素治疗同时给予乐力(氨基酸鳌合钙加维生素D)1粒,每天2次,口服;治疗组在对照组药物的基础上,加用阿伦膦酸盐10 mg,每天1次或70 mg,每周1次,口服.所有患者在治疗前和治疗后3、6、12月,应用双能X线吸收法测定腰椎及股骨颈的骨密度(BMD).结果 对照组在糖皮质激素治疗后3、6、12个月BMD与自身治疗前比较明显下降(P<0.01);治疗组腰椎的BMD与自身治疗前比较有上升趋势(12个月时有统计学差异,P<0.05),股骨颈的BMD治疗后3、6个月与自身治疗前比无变化(P>0.05),12个月有轻度降低(P<0.05).结论 单予钙剂加维生素D不能有效预防糖皮质激素相关性骨质疏松的发生,加用阿伦膦酸盐则可有效延缓糖皮质激素相关性骨量丢失.

The prospective study of alendronate on prevention of corticosteroid-induced osteoporosis

Objective To study the prevention of alendronate in corticosteroid-induced osteoporosis patients.Methods 21 cases of rheumatic patients treated with glucocorticoid were randomized into two groups:a control group receiving Osteoform(compound calcium amino acid chelate and Vitamin D)and a comprehensive therapy group receiving alendronate as welll as Osteoform.Dual-enengy X-ray absorptionmetry were carried out before and after medication at 3rd,6 th and 12 th month.Results Lumbar spine and femur BMD decreased at 3 rd,6 th and 12 th month in control group(P<0.01),however,no change of BMD happened in therapy group at 3 rd and 6 th month(P>0.05).Conclusions Comprehensive therapy of alendronate can prevent corticosteroid-induced osteoporoses,which simplex treatment can not.