伊班膦酸钠与阿仑膦酸钠对绝经后骨质疏松疗效的比较

目的:评价伊班膦酸钠与阿仑膦酸钠对绝经后骨质疏松的疗效.方法:绝经后骨质疏松妇女32例,随机分为2组,所有患者每天在接受元素钙500 mg和维生素D 200 IU治疗的同时,分别接受伊班膦酸钠和阿仑膦酸钠治疗,其中伊班膦酸钠150 mg每月1次;阿仑膦酸钠70 mg每周1次.2种药物治疗时间均为1年.通过双能X线吸收仪(DEXA)及血清Ⅰ型胶原交联C端肽(CTX-1)观察治疗中及治疗后的骨量及骨转换的变化.结果:2组患者经过1年治疗,与用药前比较,腰椎(L2-4)骨量显著上升(P＜0.05),髋部骨量增加但没有统计学意义(P＞0.05):其中伊班瞵酸钠治疗组腰椎L2-4、股骨颈、股骨大转子和全髋骨密度分别上升15.34%、4.15%、5.05%和2.49%;阿仑瞵酸钠治疗组分别上升14.50%、4.42%、1.18%和2.64%;破骨指标血清CTX-1在2组均明显下降(P＜0.05).2组之间各时点的各部位骨密度值、血清CTX-1值均无统计学差异(P＞0.05).结论:伊班膦酸钠服用方便,且对于绝经后骨质疏松的治疗效果与阿仑膦酸钠无明显差异.

The comparison of the clinical effects between ibandronate and alendronate in treatment of postmenopausal osteoporosis

Objective:To evaluate the clinical efficacy of ibandronate and alendronate in postmenopausal osteoporotic women. Methods:A total of 32 postmenopausal women with osteoporosis were randomly classified into two groups,16 in each:group A,oral ibandronate 150 mg per month;and group B,oral alendronate 70 mg per week. All patients received calcium 500 mg and Vitamin D 200 IU daily for one year. All patients were examined by DEXA(lumbar,hip)before and after treatment. At the same time the biochemical marker of bone resorption serum C-terminal telopeptide-I(CTX-1)was determined. Results:The BMD of lumbar spine(L2-4)significantly increased compared with that of pretreatment in both groups(P < 0.05),the BMD of hip locations also increased but without significance. The increases of BMD in ibandronate group were 15.34%,4.15%,5.05%,2.49% at L2-4,femoral neck,trochanter and the total of hip respectively,those in alendronate group were 14.50%,4.42%,1.18%,2.64% respectively; serum CTX-1 levels decreased dramatically in both groups(P < 0.05). The BMD change rates in all locations and the CTX-1 decreases at all time points between the two groups were not significant. Conclusion:Ibandronate is more convenient for long-term use than alendronate,which is as effective as alendronate for increasing bone mineral density and for inhibiting osteoclastic activity in treatment of postmenopausal osteoporosis.