仙灵骨葆胶囊治疗骨质疏松症128例临床总结

目的探讨仙灵骨葆胶囊治疗骨质疏松症的疗效。方法 选择骨质疏松症患者128例,口服仙灵骨葆胶囊3粒/次,2次/天,计算总有效率。结果仙灵骨葆胶囊治疗骨质疏松症总有效率为86.7%。结论 仙灵骨葆胶囊治疗骨质疏松症效果显著。     

仙灵骨葆胶囊联合钙剂治疗乳腺癌患者术后内分泌治疗后骨质疏松及对骨代谢的影响

目的:探讨中药联合钙剂对绝经后内分泌治疗后骨质疏松乳腺癌患者骨代谢的影响。方法:将2012年3月—2013年3月期间收治的绝经后乳腺癌患者92例按照随机数字表法分为观察组与对照组,每组46例,均为术后内分泌治疗后骨质疏松患者。对照组口服碳酸钙片,观察组在对照组基础上口服中药仙灵骨葆胶囊。两组疗程均为24周。比较两组治疗前后骨密度和骨代谢指标变化。结果:治疗后,两组腰椎和髂骨骨密度增加(P0.05),且观察组腰椎和髂骨骨密度高于对照组(P0.05);两组I型胶原蛋白c末端交联端肽(s-CTX)降低(P0.05),且观察组s-CTX低于对照组(P0.05);两组I型原骨胶原蛋白N-端肽(s-PINP)降低(P0.05),且观察组s-PINP低于对照组(P0.05);两组骨钙素(BGP)增加而碱性磷酸酶(ALP)降低(P0.05),且观察组BGP高于对照组而ALP低于对照组(P0.05)。结论:仙灵骨葆胶囊联合钙剂可改善绝经后内分泌治疗后骨质疏松的乳腺癌患者骨代谢障碍和骨质疏松。     

仙灵骨葆胶囊治疗社区老年原发性骨质疏松症的研究

为了现察仙灵骨葆胶囊治疗社区老年原发性骨质疏松症的临床效果,研究仙灵骨葆胶囊在治疗社区老年原发性骨质疏松症的作用争价值,本人自2009年8月以来选择社区门诊老年原发性骨质疏松症患者96例,随机分为治疗组和对照组两组,各48例,对照组口服钙尔奇D,每次600mg,每日2次,治疗组在对照组治疗的基础上口服仙灵骨葆胶囊,每次1.5克.每日2次,两组疗程半年.结果:治疗组总有效率达到95.9%,对照组总有效率52.1%,两组比较具有显著性差异P<0.01.结果表明:仙灵骨葆胶囊治疗原发性骨质疏松症的疗效确切,能有效改善和缓解原发性骨质疏松症造成的疼痛症状,且能消除小腿抽筋现象,同时能够有效提高原发性骨质疏松症患者的骨密度,并且安全可靠,无明显的不良反应,具有抑制骨吸收、降低骨转换、提高骨量的作用,对治疗社区老年原发性骨质疏松症具有重要的价值,可以推广应用.     

仙灵骨葆胶囊改善精液质量的临床研究

目的:观察仙灵骨葆胶囊改善男性不育患者精液质量的情况。方法:女方生育功能正常的男性不育患者66例,口服仙灵骨葆胶囊2~4个月,观察治疗前后精液质量并进行精子形态学分析。结果:治疗2个月后,精子密度有所提高,但无统计学差异(P>0.05);精子存活率和活动率也无明显变化(P>0.05);治疗后正常形态精子百分率明显升高,其中正常形态精子百分率≥15%者,由治疗前的25.8%(17/66)增加为57.6%(38/66)(P<0.05),而正常形态精子百分率<9%者,由治疗前的53.0%(35/66)下降为25.8%(17/66);7例少精子症者用药前精子正常形态百分率平均为5.8%,服药4个月后平均为10.9%,与服药前有明显差异(P<0.05)。治疗期间有5例患者配偶怀孕。结论:仙灵骨葆胶囊对男性精液质量有改善作用,能明显提高正常形态精子百分率,少精子症者更明显。     

仙灵骨葆胶囊联合阿仑膦酸钠对骨质疏松骨折大鼠骨痂血管形成的影响

目的探讨仙灵骨葆胶囊联合阿仑膦酸钠对骨质疏松性骨折大鼠骨痂血管形成及VEGF、BMP-2表达的影响。方法50只雌性SD大鼠随机分为假手术组(SHAM组)、模型组(MODEL组)、仙灵骨葆组(XLGB组)、阿仑膦酸钠组(ALLSN组)、联合药物组(LHYW组),10只/组,构建骨质疏松性骨折大鼠模型,放射性X线观察评估骨折愈合,双能X线检测骨密度,Mirco-CT检测骨结构形态学参数,番红O固绿染色观察骨痂组织形态学,免疫组化检测骨痂VEGF和BMP-2蛋白表达。结果所有实验大鼠均进入结果分析。与SHAM组比较,MODEL组大鼠骨折愈合评分、骨密度、骨组织形态学参数、骨痂VEGF和BMP-2表达均显著降低(P0.05),与MODEL组比较,XLGB组、ALLSN组和LHYY组骨折愈合评分、骨密度、骨组织形态学参数、骨痂VEGF和BMP-2表达均显著升高(P0.05),尤以LHYY组最高。SHAM组骨小梁结构正常,几乎均为骨性骨痂。MODEL组骨小梁明显稀疏、断裂,未见明显骨性骨痂。XLGB组和ALLSN组骨小梁增多,排列稍紊乱,大部分为骨性骨痂。LHYW组骨小梁明显增多,排列密集整齐,大量骨性骨痂。结论仙灵骨葆胶囊联合阿仑膦酸钠可能通过介导提高骨质疏松性骨折大鼠骨生长因子VEGF和BMP-2表达,促进骨痂血管形成,加速骨痂形成,增加骨密度,改善骨结构形态,促进骨折愈合。     

仙灵骨葆胶囊对骨质疏松性骨折大鼠骨生长因子及骨折愈合的影响

目的 探讨仙灵骨葆胶囊对骨质疏松性骨折大鼠骨生长因子BMP-2、IGF-1表达及骨折愈合的影响。方法 48只雌性SD大鼠随机分为：假手术组、模型组、雌二醇组、仙灵骨葆组，12只/组，采用“双侧卵巢切除术+右侧股骨干骨折髓内固定术”构建骨质疏松性骨折大鼠模型，评估骨折愈合情况，检测股骨骨痂BMD、股骨骨生物力学指标和血清骨代谢相关指标，检测骨痂BMP-2、IGF-1蛋白表达。结果 模型组较假手术组骨折愈合评分、股骨痂BMD、股骨骨生物力学指标（最大载荷、最大应力、最大位移）、骨痂BMP-2和IGF-I阳性表达均显著降低（P<0.05），雌二醇组、仙灵骨葆组较模型组骨折愈合评分、股骨痂BMD、股骨骨生物力学指标、骨痂BMP-2和IGF-I阳性表达均显著升高（P<0.05），均以仙灵骨葆组最高。模型组较假手术组血清骨代谢指标（BGP、PICP、TRACP-5b）均显著升高（P<0.05），雌二醇组、仙灵骨葆组较模型组血清骨代谢指标均显著降低（P<0.05），以仙灵骨葆组最低。结论 仙灵骨葆胶囊可能通过介导提高骨质疏松性骨折大鼠骨生长因子BMP-2和IGF-1表达，改善骨代谢，加速骨痂形成，增加骨密度，提高骨生物力学，促进骨折愈合。     

补肾通络汤联合仙灵骨葆胶囊治疗老年骨质疏松性桡骨远端骨折临床研究

目的探讨补肾通络汤联合仙灵骨葆胶囊治疗骨质疏松性桡骨远端骨折的临床疗效。方法:选取我院2021年1月—2022年12月收治的骨质疏松性桡骨远端骨折患者124例,按随机数字表法分为观察组与对照组各62例,对照组患者给予西医常规治疗,观察组在对照组基础上给予补肾通络汤联合仙灵骨葆胶囊治疗,比较两组治疗前后临床疗效,中医证候评分,以及骨折愈合时间、肿胀消退时间和疼痛缓解时间,血清骨代谢指标(血清骨钙素、I型前胶原氨基端前肽、Ⅰ型胶原C端肽β降解产物),骨密度水平,腕关节功能及并发症情况。结果:治疗后观察组总有效率(94.92%)显著高于对照组(84.75%),差异有统计学意义(P ＜0.05);治疗后两组中医证候评分、血清Ⅰ型胶原C端肽β降解产物水平均较治疗前降低,且观察组低于对照组(P ＜0.05);治疗后观察组骨折愈合时间、肿胀消退时间及疼痛缓解时间均短于对照组(P ＜0.05);治疗后两组血清骨钙素、I型前胶原氨基端前肽及骨密度水平、掌倾角、尺偏角角度均较治疗前升高,且观察组高于对照组(P ＜0.05);治疗后观察组并发症发生率(6.78%)显著低于对照组(20.34%),差异有统计学意义(P ＜0.05)。结论:补肾通络汤联合仙灵骨葆胶囊治疗老年骨质疏松性桡骨远端骨折临床疗效显著。     

仙灵骨葆对卵巢切除小鼠骨质疏松症的影响

目的 利用卵巢切除骨质疏松症小鼠模型,研究仙灵骨葆抗骨质疏松症的疗效.方法 30只129SV品系雌性小鼠随机分为三组:卵巢假切+安慰剂组(SHAM+NS,0.2 ml·d-1);卵巢切除+安慰剂组(OVX+NS,0.2 ml·d-1),卵巢切除+仙灵骨葆组(OVX+XLGB,500 mg·kg-1·d-1),持续治疗12周后取材,应用Micro-CT检测骨密度(BMD)和骨小梁结构、组织病理切片观察骨形态、三点弯曲试验和压缩试验检测骨生物力学指标.结果 Micro-CT 检测股骨BMD,OVX+NS组BMD(498.6±13.0 mg/cm2)较SHAM+NS组(636.5±12.4 mg/cm2)下降22%(P＜0.01),OVX+XLGB组BMD (561.0±18.6 mg/cm2) 与OVX+NS组相比提高了13%(P＜0.05).Micro-CT检测小鼠腰椎(L2-5)骨小梁结构显示:OVX+NS组骨小梁BV/TV、Tb.Th 分别低于SHAM+NS组22%、35%,Tb.Sp高于SHAM+NS组11%,差异有统计学意义(P＜0.05).给予仙灵骨葆治疗后,腰椎BV/TV及Tb.Th分别高于OVX+NS组15%、16%,Tb.Sp低于OVX+NS组9%,具有显著性差异(P＜0.05).三点弯曲和压缩试验检测OVX+NS组股骨和腰椎的最大载荷和最大应力,股骨最大载荷和最大应力较SHAM+NS组显著降低42%、49%,腰椎最大载荷和最大应力显著降低42%、43%(P＜0.05).仙灵骨葆治疗后,股骨和腰椎的最大载荷分别提高了75%和47%,最大应力分别提高了47%和47%,差异有统计学意义(P＜0.05).结论 仙灵骨葆能够显著提高卵巢切除引起的骨密度,改善骨微结构破坏,提高骨生物力学参数,表明仙灵骨葆具有良好的抗骨质疏松症疗效.     

仙灵骨葆胶囊治疗绝经后骨质疏松症有效性的系统评价和Meta分析

目的评价仙灵骨葆胶囊治疗绝经后骨质疏松症的有效性和安全性。方法电子检索中、英文数据库共7个(自建库时间至2017年11月),按照纳入标准和排除标准筛选文献,依据Cochrane Handbook for Systematic Reviews of Interventions(version 5.35)质量评估,并用RevMan 5.3软件进行Meta分析。结果检索到文献共1 779篇,筛选后纳入文献16篇(19项原始研究),总样本量1 492例。Meta分析得出单用仙灵骨葆胶囊对于提高腰椎骨密度疗效优于常规治疗[MD=0.08,95%CI(0.03,0.14),P=0.002];仙灵骨葆胶囊加常规干预对于提高临床有效率[OR=3.35,95%CI(1.86,6.05),P0.000 1]、改善疼痛[MD=-1.71,95%CI(-2.39,-1.03),P0.000 01]疗效优于常规治疗;在改善腰椎骨密度方面,仙灵骨葆胶囊+单一常规干预疗效明显优于单一常规干预[MD=0.06,95%CI(0.04,0.07),P0.000 01];仙灵骨葆胶囊联合常规干预在提高髋部骨密度疗效上可能优于常规干预[MD=0.08,95%CI(0.03,0.14),P=0.001]。结论仙灵骨葆胶囊在改善腰椎骨密度、提高临床有效率及改善疼痛方面疗效确切;但在改善髋部骨密度方面证据不足,总疗程可能是其重要影响因素;仙灵骨葆胶囊联合单一抗骨质疏松药物具有增效作用,与两种或以上抗骨质疏松药物联用叠加增效作用尚待研究。     

唑来膦酸治疗老年患者高转换型骨质疏松症的临床效果及其对骨代谢标志物的影响

目的分析唑来膦酸治疗老年患者高转换型骨质疏松症的临床效果及其对骨代谢标志物的影响。方法回顾性分析2013年1月至2018年1月辽宁省金秋医院收治的老年骨质疏松患者66例,其中女性60人,男性6人,年龄65～88岁,平均年龄(69.5±9.8)岁。所有纳入老年患者均为高转换型骨质疏松,分为治疗组和对照组。治疗组32例给予静脉应用唑来膦酸5mg,同时口服骨化三醇及钙剂治疗;对照组34例,仅口服骨化三醇及钙剂治疗;在治疗组中,比较治疗前后骨密度、VAS疼痛评分、骨代谢标志物PINP和β-CTX的变化。两组间比较,治疗后骨密度升高值、VAS疼痛评分下降值、骨代谢标志物PINP和β-CTX下降值的变化。观察治疗后的药物不良反应情况。结果治疗前两组患者在年龄、性别构成、骨密度值和VAS评分方面差异均无统计学意义(P0.05)。治疗组中,与治疗前相比,治疗后骨密度值明显增加(P0.05),VAS评分明显降低(P0.05),PINP和β-CTX水平均明显降低(P0.05)。与对照组比较,治疗后各时间点,治疗组骨密度值均明显增加(P0.05),VAS疼痛评分均明显降低(P0.05),PINP和β-CTX水平均明显下降(P0.05)。治疗组用药后出现5例发热,2例流感样症状,均在2～3 d内消失。结论唑来膦酸可以用于治疗老年骨质疏松,能够显著改善腰椎及髋部骨密度,有效缓解疼痛症状,改善骨代谢标志物水平,药物不良反应少。     

Effects of denosumab on bone turnover markers in postmenopausal osteoporosis

Denosumab, a fully human monoclonal antibody to RANKL, decreases bone remodeling, increases bone density, and reduces fracture risk. This study evaluates the time course and determinants of bone turnover marker (BTM) response during denosumab treatment, the percentage of denosumab‐treated women with BTMs below the premenopausal reference interval, and the correlations between changes in BTMs and bone mineral density (BMD). The BTM substudy of the Fracture REduction Evaulation of Denosumab in Osteoporosis every 6 Months (FREEDOM) Trial included 160 women randomized to subcutaneous denosumab (60 mg) or placebo injections every 6 months for 3 years. Biochemical markers of bone resorption (serum C‐telopeptide of type I collagen [CTX] and tartrate‐resistant acid phosphatise [TRACP‐5b]) and bone formation (serum procollagen type I N‐terminal propeptide [PINP] and bone alkaline phosphatase [BALP]) were measured at baseline and at 1, 6, 12, 24, and 36 months. Decreases in CTX were more rapid and greater than decreases in PINP and BALP. One month after injection, CTX levels in all denosumab‐treated subjects decreased to levels below the premenopausal reference interval. CTX values at the end of the dosing period were influenced by baseline CTX values and the dosing interval. The percentage of subjects with CTX below the premenopausal reference interval before each subsequent injection decreased from 79% to 51% during the study. CTX and PINP remained below the premenopausal reference interval at all time points in 46% and 31% denosumab‐treated subjects, respectively. With denosumab, but not placebo, there were significant correlations between CTX reduction and BMD increase (r = ?0.24 to ?0.44). The BTM response pattern with denosumab is unique and should be appreciated by physicians to monitor this treatment effectively. © 2011 American Society for Bone and Mineral Research.     

骨愈灵胶囊对绝经后骨质疏松症的疗效及骨代谢指标的影响

目的观察骨愈灵胶囊对绝经后骨质疏松症的疗效及骨代谢指标的影响。方法 148例绝经后骨质疏松症患者纳入本研究并随机分为治疗组和对照组。治疗组患者给予骨愈灵胶囊治疗,对照组患者给予雷洛昔芬治疗,两组患者治疗期限为12个月。检测治疗前和治疗12个月后2组患者腰椎正位(L_(1-4))、左股骨颈的骨密度、血清血钙、血磷、骨碱性磷酸酶(BALP)和抗酒石酸酸性磷酸酶-5b(TRAP-5b)水平变化情况以及治疗有效率和不良反应。结果治疗12个月后,两组患者腰椎正位(L_(1-4))、左股骨颈的骨密度患者均明显高于对照组,差异均有统计学意义(P0. 05);治疗12个月后,两组患者血清BALP水平较治疗前明显降低(P0. 05),血清TRAP-5b均较治疗前明显升高(P0. 05);而治疗组较对照组改善更为明显(P0. 05)。治疗组的患者治疗有效率优于对照组(P0. 05),而不良反应差异无统计学意义(P0. 05)。结论骨愈灵胶囊对绝经后骨质疏松症患者骨密度和骨代谢影响显著。     

探讨糖尿病患者的骨转换标志物的变化与骨质疏松的关系

目的探讨不同血糖控制水平糖尿病患者的骨转换情况与骨质疏松的关系,为控制患者骨折风险提供参考依据。方法将2017年1月至2018年9月于北京大学国际医院内分泌科就诊的患者494例纳入研究,分别测定糖化血红蛋白(glycosylated hemoglobin,HbA1c)与25羟维生素D(25-hydroxyvitamin D,25-VD),I型胶原氨基延长肽(type I collagen amino-lengthening peptide,P1NP),β胶原降解产物(β-crosslaps,β-Cross),骨钙素(osteocalcin,OC)。按糖化血红蛋白水平将糖尿病患者分为A组(HbA1c7.0%)、B组(7.0%≤HbA1c9.0%)、C组(HbA1c≥9.0%),同期非糖尿病体检人群45例作为对照组。对不同分组的测定结果进行统计分析。结果糖化血红蛋白与25羟维生素D、I型胶原氨基延长肽、β胶原降解产物、骨钙素均存在负相关关系(P0.05),相关系数分别为-0.11、-0.10、-0.10、-0.19.对照组4项骨代谢标志物均高于A、B、C 3个糖尿病患者组(P0.05),糖尿病患者A组的骨钙素水平高于B组和C组(P0.05)。结论糖尿病患者血糖控制情况影响骨转换标志物水平。骨钙素在骨转换标志物中是更为敏感的实验室检测指标,可能在糖尿病患者骨质疏松的诊断和治疗监测中更值得关注。     

金天格胶囊治疗骨质疏松症疗效观察

目的通过观察单纯服用金天格胶囊及金天格胶囊与福美加片联合服用3月、6月后骨质疏松患者的治疗效果及对骨代谢的影响。方法选取我院2012年至2014年龄在65岁至75岁被诊断为骨质疏松症的老年女性患者共106例,随机分成2组。对照组:金天格胶囊3粒,每日三次。治疗组:在西药(钙尔奇D片,每日1片,福美加片,每周1片)抗骨质疏松治疗的基础上加用金天格胶囊3粒,每日三次。分别于治疗前后3月、6月行血钙、磷、血清碱性磷酸酶(ALP)、尿钙/肌酐(U-Ca/Cr)测定,于治疗6月后行MBD测定分析其治疗前后及治疗组与对照组的差异。结果单用金天格胶囊治疗骨质疏松症,治疗3月后症状明显减轻。治疗3月后血钙增加,血清碱性磷酸酶(ALP)、尿钙/肌酐(U-Ca/Cr)均减少,差异有统计学意义(P0.05),血磷水平无明显变化,差异无统计学意义。治疗6月后血钙趋于稳定,与治疗3月后比较无明显增加,差异无统计学意义,治疗6月后血清碱性磷酸酶(ALP)可进一步下降,与治疗前比较差异有统计学意义(P0.01)。与福美加片联合使用总有效率提高,治疗3月后血钙增加,血清碱性磷酸酶(ALP)、尿钙/肌酐(U-Ca/Cr)均减少,差异有统计学意义(P0.05),6月后血钙与治疗3月后比较也无明显增加(P0.05),血清碱性磷酸酶(ALP)、尿钙/肌酐(U-Ca/Cr)均较治疗前明显减少(P0.01),且治疗组较对照组疗效显著,两组间差异有统计学意义(P0.05)。6月后复查骨密度(MBD)治疗前后及对照组与治疗组之间均明显增加,差异有统计学意义(P0.05)。结论金天格胶囊治疗骨质疏松疗效显著,能有效地缓解症状,提高骨密度,与西药福美加片联合治疗效果更佳。     

Effects of 3 years of lasofoxifene treatment on bone turnover markers in women with postmenopausal osteoporosis

The aims of this study were to describe the changes in bone turnover markers (BTMs) in response to lasofoxifene therapy; to describe the changes in BTMs in the individual; and to examine the relationships between BTM levels on treatment and treatment outcomes. Women (n=1126) aged 59-80years with femoral neck or spine bone mineral density T-scores ≤-2.5 were randomized to lasofoxifene 0.25mg/d, 0.5mg/d, or placebo for 5years. We measured serum C-telopeptide of type I collagen (CTX) and serum procollagen I N-propeptide (PINP), osteocalcin, and bone alkaline phosphatase (ALP) at baseline and at 1, 3, 6, 12, 24, and 36months. Lasofoxifene therapy resulted in a decrease in the concentrations of bone resorption and bone formation markers compared with placebo; the decrease was maximal between 6 and 24months. The effect of lasofoxifene 0.5mg/d was similar to that of lasofoxifene 0.25mg/d. The decrease in bone ALP was less than the decreases in CTX, osteocalcin, and PINP. Lasofoxifene therapy 0.5mg/d resulted in BTM-defined response rates for CTX (decrease in concentration from baseline >60%), PINP (>50%), and bone ALP (>30%) of 35%, 45%, and 43% of women at month 12, respectively, compared with placebo responses of 4%, 4%, and 7%. In contrast, the increase in BMD took longer (50% responded after 36months of lasofoxifene 0.5mg/d) and was not as specific (15% of placebo group responded). Bone density change was weakly inversely correlated with change in the concentrations of BTMs. BTMs may prove useful in the monitoring of the response to lasofoxifene treatment for women with postmenopausal osteoporosis early in the course of treatment.     

Biochemical markers of bone turnover for the clinical investigation of osteoporosis

The non-invasive assessment of bone turnover has received increasing attention over the past few years because of the need for sensitive markers in the clinical investigation of osteoporosis. Markers of bone formation include the serum measurement of total and bone-specific alkaline phosphatase, osteocalcin, and type I collagen extension peptides. Assessment of bone resorption can be achieved by measurement of urinary hydroxyproline, urinary excretion of the pyridinium crosslinks (pyridinoline and deoxypyridinoline), and by measurement of plasma tartrate-resistant acid phosphatase activity. For the screening of bone turnover in women at the menopause, and for the assessment of the level of bone turnover in elderly women with vertebral osteoporosis, serum osteocalcin and urinary pyridinoline appear to be the most sensitive markers, so far. Programs combining bone mass measurement and assessment of bone turnover by several markers in women at the time of menopause are being developed in an attempt to improve the assessment of the risk for osteoporosis. Efforts are made to develop more convenient assays and to identify other markers of bone turnover. In future a battery of various specific markers is likely to improve the assessment of the complex and subtle abnormalities of bone metabolism that characterize the various aspects of osteoporosis.     

Prognostic interest of bone turnover markers in the management of postmenopausal osteoporosis

ObjectiveThe aim was to review the literature dealing with the use of biochemical bone turnover markers (BTM) as predictors of bone loss and individual risk of fracture in postmenopausal osteoporosis.MethodsWe performed a generalized search in MEDLINE using Mesh Database from 1995 through 2009 with the following terms “biological markers” with “osteoporosis” or “bone resorption”, or “bone fracture”, “fracture risk”. From this research, 197 abstracts were read, 91 articles were screened then 43 original articles were selected.ResultsIn most of the selected articles, the upper limit of the premenopausal range was used as a cut-off definition for increased bone resorption. Based on this review, we found a moderate and positive relationship between baseline level of BTM and rate of bone loss, more particularly for high level of BTM over 2 SD, especially when high turnover is constant in repeated sampling. In addition, an increase in BTM levels is associated with an increase in the risk of hip and non-vertebral fractures in elderly women over 75 years old. This is especially demonstrated with bone resorption markers (e.g. uCTX) in the highest quartile with an 1.7 to 2.2 fold increase. The combination of data from bone mineral density (BMD) and bone resorption markers may improve fracture prediction.ConclusionThe measurement of BTM, together with the assessment of other risk factors including low BMD, will improve the prediction of risk facture, but there is a lack of practical guidelines.     

骨代谢生化标志物在原发性骨质疏松症药物治疗中的应用

[目的]分析骨代谢生化标志物在骨质疏松症治疗中对药物应用的指导意义,为骨质疏松药物治疗探索一条精准有效地治疗途径。[方法]采用自身前后对照临床研究,56例患者根据Ⅰ型前胶原N-端前肽(P1NP)与β-胶原特殊序列(β-cross Laps)测量值分为低骨转换组(30例)与高骨转换组(26例)。每组随机分别给予2种治疗方案:特立帕肽(20μg/d)与唑来膦酸注射液(5 mg/年),治疗时间为26个周,期间定期观察β-cross Laps、P1NP、腰椎、股骨颈骨密度(BMD)以及VAS疼痛评分的变化情况。[结果]在高、低骨转换组中,特立帕肽治疗后P1NP与β-cross Laps均较治疗前浓度升高(P<0.05),唑来膦酸治疗后P1NP与β-cross Laps均较治疗前浓度降低(P<0.05);低骨转换组特立帕肽治疗后腰椎BMD升高较唑来膦酸显著(P<0.05),高骨转换组唑来膦酸治疗后股骨颈BMD升高较特立帕肽显著(P<0.05);低骨转换组特立帕肽治疗后骨痛缓解优于唑来膦酸(P<0.05),高转换组中两种药物均能缓解骨痛,差异无统计学意义(P>0.05)。[结论]在原发性骨质疏松症治疗中,应以骨生化标志物作为药物选择的依据:低骨转换状态下以促成骨药物为主,高骨转换状态下以抑制骨吸收药物为主。     

金天格胶囊在绝经后骨质疏松症的治疗效果分析

目的评价金天格胶囊治疗女性绝经后骨质疏松症的临床疗效。方法选择绝经后骨质疏松症患者86例,采用随机、对照试验设计,分为治疗组和对照组,其中治疗组52例,应用金天格胶囊,对照组34例,应用阿仑磷酸钠。结果治疗组在疼痛控制上明显优于对照组,两组在骨代谢指标包括雌二醇(E2)、甲状旁腺素(PTH)、总25-羟维生素D(Vit Dtl)、血清总I型胶原氨基端延长肽(T-PINP)、N-端骨钙素(N-MID)和β-胶原特殊序列(β-Cross)观测结果上无明显差异。结论金天格胶囊治疗绝经后骨质疏松症效果优于阿仑磷酸钠,值得临床推荐。