不同给药方案阿仑膦酸钠治疗绝经后妇女骨质疏松症18个月效果研究

目的阿仑膦酸钠是临床治疗绝经后妇女骨质疏松症的首选药物。本实验观察阿仑膦酸钠不同给药方案对绝经后妇女骨质疏松症的治疗效果以及不良反应的发生情况。方法本实验为开放、随机、平行对照临床研究。纳入西安两社区绝经后妇女共80名,年龄49～79岁,绝经年限3～31年。实验分为低剂量组和常规剂量组。低剂量组为每两周口服阿仑膦酸钠一次,每次70mg,疗程18个月。常规剂量组为每周口服阿仑膦酸钠一次,每次70mg,疗程18个月。两组同时每日服用钙尔奇D3600mg。实验主要观察指标为:第二腰椎到第四腰椎(L2-L4)、股骨颈、大转子、股骨干骨密度值变化,血液指标(血钙、血磷、碱性磷酸酶),肝肾功能指标(丙氨酸氨基转移酶、血肌酐),不良反应及新发骨折情况。结果 80例患者全部进入结果分析:①骨密度测定:每组患者治疗18个月后L2-L4、股骨颈、股骨大转子、股骨干的骨密度与治疗前相比均明显升高,差异有显著性意义(P﹤0.05)。低剂量组与常规剂量组相比L2-L4骨密度、股骨颈骨密度、股骨干骨密度值差异无统计学意义(P﹥0.05),表明两种给药方案相比增加骨密度效果相似。②两组患者血液指标及肝肾功能指标治疗前后均在正常范围内,显示两种用药方法均安全可靠。③不良反应主要为上腹部不适,两组不良反应差异有统计学意义(P﹤0.05),低剂量组显著低于常规剂量组。④两组患者均无新发骨折病例。结论阿仑膦酸钠治疗绝经后妇女骨质疏松症安全有效,低剂量用药方案与常规剂量用药方案相比增加骨密度效果和药物安全性相似,用药更加简单方便,不良反应更小,经济效益更高,是临床值得推荐的用药方案。     

针刺对实验性骨质疏松大鼠股骨骨折的预防作用

目的研究"健脾益肾强骨针法"对去势SD大鼠股骨骨质疏松性骨折的预防作用。方法 6月龄SD大鼠在去势3个月检测骨质疏松症模型造模成功后,被随机分为3个组:对照组、阿仑膦酸钠组和针刺组。针刺组针刺足三里、肾俞、大杼,每日1次,每周5次,连续治疗6个月;阿仑膦酸钠组每日皮下注射阿仑膦酸钠,每日1次,连续治疗6个月;对照组每日在其他两组治疗期间进行同样抓放。治疗6个月后,检测包括在体股骨骨折最小外力、新鲜股骨形态学、骨密度、骨力学性能等反映股骨的硬度和弹性的指标。结果针刺组、阿仑膦酸钠组的在体股骨骨折最小外力明显大于对照组;针刺组新鲜股骨近端横径明显小于阿仑膦酸钠组和对照组;针刺组、阿仑膦酸钠组骨密度明显大于对照组;针刺组、阿仑膦酸钠组离体股骨的部分力学性能指标(如压缩、拉伸)明显高于对照组。结论 1针刺足三里、肾俞、大杼6个月具有预防绝经后骨质疏松症模型大鼠股骨骨折的作用,其机制可能与针刺促进股骨的形态适应、增加骨密度、提高骨的抗外力性能密切相关。2"健脾益肾强骨针法"与阿仑膦酸钠均能提高绝经后骨质疏松大鼠在体股骨骨折最小外力,但针刺的作用机制与阿仑膦酸钠不完全相同。     

阿仑膦酸钠治疗COPD患者骨质疏松症的疗效及对肺功能的影响

目的 评价阿仑膦酸钠治疗慢性阻塞性肺疾病(COPD)患者骨质疏松症的近期临床疗效及对肺功能的影响。方法 COPD患者38例，经骨密度检查，并根据WHO诊断标准确诊为骨质疏松症，连续服用阿仑膦酸钠和碳酸钙，于治疗6个月后复测患者骨密度、肺功能以及血清钙、磷、碱性磷酸酶(ALP)、血清骨钙素(BGP)和晨尿游离脱氧吡啶啉排泄率(Dpd／Cr)；在服药期间每月在门诊随诊1次，观察患者临床症状、血常规及肝肾功能等生化指标。结果 治疗6个月后患骨痛症状改善，FEV1及FEV1％有显著提高，腰椎正、侧位、左股骨颈、左股骨近端及Ward’s三角的骨密度均有不同程度增高。治疗前FEV1、治疗后FEV1变化值／XFEV1与腰椎正、侧位骨密度变化值△APL1-4及△LatL2-4间呈正相关。治疗后血清钙、BGP水平升高；血清磷、ALP水平及晨尿Dpd／Cr值均下降。无严重的副作用及过敏反应。结论 阿仑膦酸钠是治疗COPD合并骨质疏松症的安全有效的药物，可提高患者骨密度，也有利于肺通气功能的改善，特别适合于病情较重或有骨折的患者。     

金天格辅助治疗老年股骨转子周围骨折的疗效分析

目的 评价老年股骨转子周围骨折术后使用金天格胶囊辅助健骨治疗的疗效。方法 选取股骨近端防旋髓内钉治疗的老年股骨转子周围骨折的患者80例,随机分为A、B组各40例,研究组采用金天格胶囊联合阿仑膦酸钠,对照组单独采用阿仑膦酸钠口服,连续观察12个月;评价治疗后的疼痛缓解情况和髋部骨密度（BMD)变化,随访复查X光平片、CT评定骨折愈合情况。以视觉模拟疼痛评分（VAS)方法对患者治疗后3、6个月疼痛疗效进行评估,并在治疗后6、12个月测量髓部骨密度（BMD),在术后3、6个月评定骨折愈合情况。结果 两组治疗后VAS评分、髋部BMD值存在差异（P < 0. 05),研究组优于对照组,研究组骨折愈合率（97.4% )高于对照组（94.5% ),P<0.05。结论 联合应用金天格胶囊能显著改善老年股骨转子周围骨折术后疼痛,增加髋部BMD值,改善骨折愈合。     

阿仑膦酸钠治疗男性骨质疏松症的临床研究

目的 观察阿仑膦酸钠治疗男性骨质疏松症的疗效和安全性。方法 ３７例男性骨质疏松症患者,选用阿仑膦酸钠治疗６个月。比较治疗前后患者疼痛、骨密度、血生化指标和副反应的变化。结果 经６个月治疗后,患者疼痛明显改善,腰椎、股骨颈和髋部骨密度增加,尿钙与尿肌酐比值（Ｃａ／Ｃｒ）及尿羟脯氨酸与尿肌酐比值（Ｈｏｐ／Ｃｒ）降低,副反应轻微且耐受性好。结论 阿仑膦酸钠治疗男性骨质疏松症疗效显著、安全性好。     

补肾壮骨冲剂对老年男性骨量减少及骨质疏松患者骨代谢指标影响的临床观察

目的 通过比较补肾壮骨冲剂组服药前、服药半年后骨密度及骨代谢指标的变化情况,并将补肾壮骨冲剂组与阿仑膦酸钠及钙尔奇D组分别做对比,观察补肾壮骨冲剂治疗老年男性骨量减少及骨质疏松、改善其骨代谢的临床疗效。方法 采用电化学发光免疫分析法分析血清中PINP、β-Crosslaps及N-MID的含量;采用美国GE公司生产的Lunar Prodigy双能X线（DXA）骨密度仪,检测各部位BMD;将研究对象按就诊时间分为3组,补肾壮骨冲剂组服用补肾壮骨冲剂+钙尔奇D,阿仑膦酸钠组服用阿仑膦酸钠+钙尔奇D,钙尔奇D组只服用钙尔奇D。 结果 补肾壮骨冲剂组治疗半年后血清中的PINP、β-Crosslaps及 N-MID下降显著;与治疗前相比,左侧股骨颈、Ward’s三角和左侧股骨近端处的BMD提高明显;补肾壮骨冲剂组改善老年男性骨代谢及提高骨密度的效果优于钙尔奇D组;与临床疗效公认的阿仑膦酸钠组比较,补肾壮骨冲剂显示出与其相近的改善骨代谢和提高骨密度疗效。结论 补肾壮骨冲剂是治疗老年性骨量减少及骨质疏松、提高骨量、改善老年男性骨代谢情况的安全有效药物。     

利塞膦酸钠不同给药方式治疗男性骨质疏松症疗效分析

【摘要】〓目的〓观察利塞膦酸钠不同给药方式在男性骨质疏松症治疗中的疗效和耐受性。方法〓共纳入72例男性骨质疏松症患者,其中38例为口服利塞膦酸钠每日5 mg;34例为每周35 mg口服,随访1年。分别测定两组患者治疗前后L1~L4椎体骨密度值和骨转化指标,并观察两组骨质疏松性骨折的发生率及服药后的不良反应。结果〓口服利塞膦酸钠治疗后,患者L1~L4椎体和股骨颈的骨密度值较治疗前上升显著,每日口服组和每周口服组间比较无统计学差异(P>0.05);两组间的骨转化指标和骨折发生率亦无统计学差异。结论〓观察口服利塞膦酸钠治疗后1年,每周口服35 mg与每日口服5 mg比较,均能有效地提高骨质量。     

74例老年骨质疏松患者应用鲑鱼降钙素联合阿仑膦酸钠治疗的疗效观察

目的　评估联合应用鲑鱼降钙素与阿仑膦酸钠治疗缓解老年性骨质疏松症患者骨关节疼痛及血清骨钙素(BGP)、降钙素(CT)及骨密度(BMD)水平的变化。方法 联合应用鲑鱼降钙素和阿仑膦酸钠治疗本院收治的74例老年性骨质疏松症患者,给予鲑鱼降钙素50IU肌肉注射,隔日1次,连续使用15次后改为口服阿仑膦酸钠1粒/周,共经6个月治疗,采用数字模拟评分法(VAS)比较治疗前、后全身骨关节疼痛程度,治疗前、后骨钙素、降钙素及第2～第4腰椎(L2-4 )、股骨颈、Ward区骨密度水平的变化,并进行统计学分析。结果 鲑鱼降钙素联合阿仑膦酸钠治疗老年性骨质疏松症患者6个月后,对缓解骨关节疼痛症状疗效良好,治疗前与治疗后比较差异显著(P<0.01);治疗前后骨密度、血清骨钙素和降钙素水平均有显著差异（P<0.05）。结论 鲑鱼降钙素联合阿仑膦酸钠治疗老年性骨质疏松症使血清降钙素的水平明显升高,骨钙素水平明显降低,能显著减轻患者骨关节疼痛,改善症状,并增加骨密度,对老年性骨质疏松症有明显的疗效。     

去势雌性大鼠骨质疏松症的药物干预疗效的评价

目的：评价阿仑膦酸钠、埃本膦酸钠和泰舒对去势雌性大鼠骨质疏松症的治疗效果。方法：手术切除雌性大鼠卵巢制成骨质疏松模型，随机分为4组，即阿仑膦酸钠组、埃本膦酸钠组、泰舒组和对照组，分别给予相应干预药物持续处理6个月。治疗模型给药前、给药后2个月和6个月，分别测定全身骨密度。治疗结束后，进行股骨干重、灰重、骨矿含量、骨生物力学 和骨组织形态计量学测定。结果：阿仑膦酸盐和埃本膦 钠组治疗后6个月后全身骨密度有明显升高，分别增高6．49％和7％；而泰舒组仅上升1．7％，对照组几无变化。埃本膦酸盐治疗后大鼠全身、腰椎骨密度及股骨干重、灰重、最大抗弯曲载荷和骨小梁面积均较其他组高。结论；埃本膦酸钠是比阿仑膦酸钠更有效的一种骨质疏松症治疗药物。     

唑来膦酸与阿仑膦酸钠预防PKP术后再骨折的效果分析

目的比较分析静脉滴注唑来膦酸与口服阿仑膦酸钠预防经皮椎体后凸成形(PKP)术后预防骨质疏松性再骨折的效果。方法纳入2014-01—2017-12行PKP手术并获得完整随访的92例骨质疏松性胸腰椎压缩骨折,术后进行规范抗骨质疏松治疗,46例在口服碳酸钙D3片、骨化三醇胶丸基础上口服阿仑膦酸钠治疗(阿仑膦酸钠组),46例在基础治疗后静脉滴注唑来膦酸治疗(唑来膦酸组)。结果 92例均获得随访,随访时间平均16(12～24)个月。阿仑膦酸钠组与唑来膦酸组术后3 d疼痛VAS评分、伤椎椎体前缘高度比值、伤椎Cobb角差异无统计学意义(P0.05)。唑来膦酸组再次骨折发生率低于阿仑膦酸钠组,末次随访时骨密度高于阿仑膦酸钠组,差异有统计学意义(P 0.05)。结论 PKP术后出现骨质疏松性再骨折的主要原因是骨质疏松症控制不佳,对于此类患者术后应重视规范抗骨质疏松治疗,而唑来膦酸预防骨质疏松性再骨折的效果明显优于口服阿仑膦酸钠。     

The effect of intravenous pamidronate versus oral alendronate on bone mineral density in patients with osteoporosis

Intravenous pamidronate is frequently used for the treatment of osteoporosis in patients who cannot tolerate oral bisphosphonates. The aim of the present study was to compare the changes in bone mineral density (BMD) after 1 year of treatment with either oral alendronate or intravenous pamidronate in patients with osteoporosis. We studied 40 consecutive patients starting treatment for osteoporosis: 20 received oral alendronate 10 mg/day and 20 received intravenous pamidronate 60 mg/3 months. Patients were started on intravenous pamidronate in the case of intolerance (within 1 month of start of treatment) of an oral bisphosphonate or in the case of contraindications for an oral bisphosphonate. BMD (spine and total hip) was measured with dual X-ray absorptiometry (DEXA) at the start of treatment and after 1 year. The BMD of the lumbar spine increased by 4.0% (P<0.05 vs baseline) in both groups, and the BMD of the hip increased by 3.3% and 2.9% (P<0.05 vs baseline) in the alendronate and pamidronate groups, respectively. The increases in BMD of the vertebral spine and the total hip after 1 year are comparable in the alendronate and pamidronate groups. We conclude that intravenous pamidronate can be used successfully as an alternative treatment in patients with gastrointestinal intolerance of an oral bisphosphonate.     

Effects of short-term alendronate on bone mineral density in haemodialysis patients

BACKGROUND: Low bone mineral density (BMD) is common in dialysis patients. Low BMD predicts the fracture risk in the general population. Bisphosphonate therapy improves BMD and lowers the fracture risk in many populations, but has not been tested in dialysis patients because of concerns about toxicity. In this investigation, the effect of a short course of alendronate on BMD in haemodialysis (HD) patients is evaluated. METHODS: Thirty-one healthy HD patients were randomized to placebo versus 40 mg alendronate, taken once a week for 6 weeks. Hip and lumbar spine BMD were measured by dual energy X-ray absorptiometry at baseline and at 6 months. Osteocalcin, parathyroid hormone, calcium, phosphorous and alkaline phosphatase levels were assayed at baseline and at 1, 3 and 6 months. RESULTS: The BMD and T-scores in specific regions of the hip were stable in the treatment group and decreased in the placebo group (P=0.05). The lumbar spine density increased minimally in both groups. In the treatment group, osteocalcin levels declined significantly at 1 month (P<0.05) and remained low. The main side-effect in the alendronate group was occurrence of gastroesophageal reflux symptoms in three subjects. CONCLUSIONS: Low-dose alendronate, administered for a limited duration, appears to be well tolerated in dialysis patients. The BMD and T-scores declined at certain hip regions in the placebo group over 6 months, while remaining stable in the treatment group, suggesting a bone-preserving effect of alendronate. Further studies of longer duration, and including examination of bone histology, are needed to assess whether bisphosphonates can be used to preserve BMD in dialysis patients.     

The distal radial fracture in elderly women and the bone mineral density of the lumbar spine and hip

The incidence of distal radial fractures in elderly women is high and is associated with osteoporosis and hip fracture. Osteoporosis can be detected by measuring the bone mineral density (BMD) of the lumbar spine or hip with dual energy X-ray absorptiometry. Low BMD of the lumbar spine or hip is a strong predictor for future vertebral deformities and hip fractures. At present, elderly women with a distal radial fracture are not investigated for osteoporosis on a routine basis. The BMD of the lumbar spine and hip were assessed in 94 women (mean age, 69 years) with a distal radial fracture. A low BMD was found in 85% of the patients, and osteoporosis was diagnosed in 51%. The mean BMD decreased by 0.04 SD per year and there was a significant relationship between post-menopausal status and decreased BMD of the hip. The BMD in patients treated with bisphosphonate medication increased significantly in 1 year. As more than half of the elderly women with a distal radial fracture have osteoporotic BMD values for the lumbar spine or hip, it is our opinion that such patients should be screened for osteoporosis.     

Differential effects of teriparatide on BMD after treatment with raloxifene or alendronate.

We investigated the effects of 18 months of treatment with teriparatide in patients previously treated with long-term antiresorptive therapy using bone turnover markers and bone densitometry. Previous raloxifene treatment allowed for teriparatide-induced early bone marker and BMD increases comparable with previously published results for treatment-n?ive patients. Conversely, previous alendronate treatment reduced the bone marker and BMD response. INTRODUCTION: Teriparatide [rhPTH(1-34)] has been shown to increase BMD and reduce the risk of fracture in postmenopausal women with osteoporosis. Our objective was to investigate the skeletal effects of 18 months of treatment with teriparatide in women whose osteoporosis was previously treated with either alendronate or raloxifene. MATERIALS AND METHODS: Daily subcutaneous injections of 20 microg teriparatide were administered for 18 months to 59 postmenopausal women, 60-87 years of age, with BMD T-scores 相似文献   

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。     

唑来膦酸盐(5mg)干预绝经后骨质疏松症对骨量的影响

 目的 观察唑来膦酸盐(5 mg, 单次)治疗绝经后骨质疏松症妇女骨密度和跌倒风险的作用。方法 采用随机对照研究, 观察期为1 年。91 例绝经后骨质疏松症妇女经知情同意后, 随机分为两组。唑来膦酸盐组45 例院唑来膦酸盐5 mg(30 min 静脉滴注, 1 次), 骨化三醇0.25 ug 和钙剂600 mg 及维生素D 125 ID(1 次/d, 1 年); 对照组46 例院骨化三醇0.25 滋g 和钙剂600 mg 及维生素D 125 ID(1 次/d, 1 年)。用药前和用药12 个月后测量腰椎尧髋部及股骨颈骨密度和跌倒风险, 并进行患者不良反应和随访情况进行比较。结果 干预1 年后, 两组各有41例患者得到随访。与干预前自身比较, 唑来膦酸盐组患者腰椎尧髋部总量和股骨颈骨量均明显增加, 分别为5.8%, 3.9%和2.9%, 差异均有统计学意义; 对照组患者腰椎骨量与干预前自身比较有明显增加, 达4.4%。两组患者经治疗后跌倒风险较治疗前均明显降低, 组间比较差异无统计学意义。唑来膦酸盐组患者未见无法耐受的不良反应。结论 唑来膦酸盐(5 mg, 单次)治疗绝经后骨质疏松症可明显提高腰椎尧髋部和股骨颈骨密度, 联合应用活性维生素D 能进一步降低跌倒风险。唑来膦酸盐(5 mg)是临床骨质疏松症长期治疗疗效得以保证的重要手段。     

Quantification of osteopenia in hip fracture patients

Osteopenia was assessed in 56 consecutive hip fracture patients by using dual photon absorptiometry of the lumbar spine and uninjured, contralateral femoral neck and by performing iliac crest biopsy. Of the 56 patients, 47 were female and 9 were male. The mean age was 78 years. There were 31 femoral neck and 25 intertrochanteric fractures. Two comparison populations were also studied. Population 1 consisted of 269 postmenopausal females older than 60 years of age with no history of fracture who were referred for dual photon absorptiometry of the lumbar spine as screening for osteoporosis. Population 2 included 94 patients with vertebral compression fractures who underwent transilial biopsy to evaluate osteoporosis. All transilial biopsies were assessed with the use of quantitative histomorphometry. Dual photon absorptiometry of the lumbar spine indicated that 76.9% of the hip fracture patients had severe bone loss (less than 1 gm/cm2). Nevertheless, no difference in spinal bone density was found when the hip fracture patients were compared to population 1. No difference in density of the lumbar spine or femoral neck was found in patients in the hip fracture group when intertrochanteric and femoral neck fractures were compared. No difference in histomorphometric measurements of total bone, cortical bone, and cancellous bone volume was noted between the hip fracture patients and population 2. There was no difference noted when the intertrochanteric and femoral neck fracture patients were compared. No evidence of osteomalacia was noted in any group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Alendronate decreases the fracture risk in patients with prostate cancer on androgen‐deprivation therapy and with severe osteopenia or osteoporosis

OBJECTIVE

To evaluate changes in bone mass and fracture risk in patients with prostate cancer on androgen‐deprivation therapy (ADT) and with a basal T‐score of >?2.0, who were treated with an oral bisphosphonate, as such patients treated with ADT are at increased risk of bone loss and bone fracture.

PATIENTS AND METHODS

We selected 61 patients with prostate cancer treated with ADT; 31 were treated with oral alendronate 70 mg once‐weekly and a control group of 30 were not. At baseline and 12 months we measured bone mineral density (BMD) of the lumbar spine, femoral neck and total hip by dual‐energy X‐ray absorptiometry. All patients had severe osteopenia or osteoporosis at baseline. The risk of femoral neck fracture was calculated at baseline and 12 months (Z‐score 2.7).

RESULTS

Patients treated with alendronate had a significant increase in BMD at the lumbar spine and femoral neck after 1 year of follow‐up, with mean (sd ) values of 1.06 (0.26) vs 1.01 (0.21) g/cm² at baseline (P < 0.001), and 0.75 (0.07) vs 0.73 (0.07) g/cm² (P = 0.03), respectively, while the control group had a significant loss of BMD at the total hip of 0.79 (0.14) vs 0.81 (0.13) g/cm² (P = 0.03). BMD was significantly improved at the three locations in patients treated with alendronate compared with the control group, with differences at the lumbar spine, femoral neck and total hip of 0.05 (0.07) vs 0.01 (0.10) (P = 0.001), 0.01 (0.04) vs ?0.002 (0.03) (P = 0.04) and 0.01 (0.04) vs ?0.01 (0.02) g/cm², respectively (P = 0.001). Patients treated with alendronate had a significant decrease in the fracture risk at the femoral neck, by ?0.54 (1.29) (P = 0.04) after 1 year of follow‐up.

CONCLUSIONS

Treatment with once‐weekly 70 mg alendronate significantly improved the BMD at the lumbar spine and femoral neck in patients with prostate cancer with severe osteopenia or osteoporosis and on ADT, and significantly decreased the risk of femoral neck fracture.     

阿仑膦酸钠治疗伴骨质疏松症的髋部骨折

目的　观察阿仑膦酸钠 (固邦 )治疗髋部骨折的骨质疏松症患者的临床疗效及安全性。方法　对 77例髋部骨折的骨质疏松症患者进行为期 1年随机双盲对照研究。用骨密度测量仪测定骨密度。结果　固邦治疗 1年时 ,腰椎、股骨颈、Wards三角、大转子骨密度分别平均增加 7 0 %±13 0 %、7 3%± 11 1%、4 6 %± 5 9%、4 5 %± 3 2 % ,安慰剂组增加 - 2 0 %± 4 5 %、0 9%± 6 9%、-3 6 %± 4 9% ,- 1 14 %± 6 0 %、两组差异有显著意义 (P <0 0 5 )。治疗前后用药组及对照组血Ca、血P、血ALP、血BGP及尿Pyd/Cr差异均无显著性意义。副作用轻微 ,为一过性 ,主要为消化道反应。结论　阿仑膦酸钠治疗骨质疏松症骨折显著有效并且安全     

Differences in Site-Specific Fracture Risk Among Older Women with Discordant Results for Osteoporosis at Hip and Spine: Study of Osteoporotic Fractures

To examine the fracture pattern in older women whose bone mineral density (BMD) T-score criteria for osteoporosis at hip and spine disagree, hip and spine BMD were measured in Study of Osteoporotic Fractures participants using dual energy X-ray absorptiometry (DXA). Hip osteoporosis was defined as T-score ≤−2.5 at femoral neck or total hip, and spine osteoporosis as T-score ≤−2.5 at lumbar spine. Incident clinical fractures were self-reported and centrally adjudicated. Incident radiographic spine fractures were defined morphometrically. Compared to women with osteoporosis at neither hip nor spine, those osteoporotic only at hip had a 3.0-fold age- and weight-adjusted increased risk for hip fracture (95% confidence interval [CI]: 2.4–3.6), and smaller increases in risk of nonhip nonspine (hazard ratios [HR] = 1.6), clinical spine (odds ratio [OR] = 2.2), and radiographic spine fractures (OR = 1.5). Women osteoporotic only at spine had a 2.8-fold increased odds of radiographic spine fracture (95% CI: 2.1–3.8), and smaller increases in risk of clinical spine (OR = 1.4), nonhip nonspine (HR = 1.6), and hip fractures (HR = 1.2). Discordant BMD results predict different fracture patterns. DXA fracture risk estimation in these patients should be site specific. Women osteoporotic only at spine would not have been identified from hip BMD measurement alone, and may have a sufficiently high fracture risk to warrant preventive treatment.