Adjuvant Therapy With Sodium Alendronate for the Treatment of Experimental Periodontitis in Rats

Background: This study assesses the effects of topical sodium alendronate (SA) as an adjuvant to the mechanical treatment of ligature‐induced periodontitis in rats. Methods: Ninety animals were subjected to the induction of periodontitis via the installation of a ligature around the mandibular left first molar. After 7 days, the ligature was removed, and the animals were distributed into the following groups: 1) NT group (n = 30), no treatment; 2) SRP group (n = 30), scaling and root planing (SRP) and local irrigation with physiologic saline solution; and 3) SRP/SA group (n = 30), SRP and local irrigation with SA (10^?5 M). Ten animals from each group were euthanized at 7, 15, and 30 days after treatment. Histologic and histometric analyses were performed in the furcation region. The percentage of bone in the furcation (PBF) was measured. Immunohistochemical analyses for detecting the receptor activator of nuclear factor‐κB ligand (RANKL), osteoprotegerin (OPG), tartrate‐resistant acid phosphatase (TRAP), and activated caspase‐3 were performed at the furcation region. Results: Compared with the other groups, the SRP/SA group showed less local inflammation and better tissue reparation during the entire experiment. There was more PBF in the SRP/SA group than in the other groups at days 7 and 15. Stronger OPG immunolabeling and weaker RANKL immunolabeling were observed in the SRP/SA group at 15 and 30 days. There were fewer TRAP‐positive cells in the SRP/SA group than in the NT group at all of the time points. There was no difference in the number of activated caspase‐3‐positive osteocytes among groups and time points. Conclusion: It can be concluded that topical use of SA as an adjuvant to SRP is effective in the treatment of experimental periodontitis.     

阿仑膦酸钠对兔破骨细胞功能的影响

用骨陷窝形成分析法观察阿仑膦酸钠对体外培养破骨细胞功能的影响，探讨可能的作用机制。在建立兔破骨细胞培养方法的基础上，用不同浓度的阿仑膦酸钠分别与骨片或成骨细胞提前作用，然后再将骨片或成骨细胞分别与破骨细胞共同培养。结果发现当阿仑膦酸钠（10^-11,10^-9,10^-7mol/L)与骨片预处理后，破骨细胞在骨片上形成的骨吸收陷窝数目减少，其抑制率分别为19．5％（P＜0．05）、49．0％（P＜0．01）和74．5％（P＜0．01）。用阿仑膦酸钠（10^-9,10^-7,10^-5mol/L)预处理成骨细胞后，仅在高浓度（10^-5mol/L）时可见破骨细胞骨吸收陷窝的数目明显减少，其抑制率为62．8％（P＜0．01）。结果表明阿仑膦酸钠能直接或通过成骨细胞间接抑制破骨细胞的骨吸收活性。     

Comparison of effects of alendronate and raloxifene on lumbar bone mineral density, bone turnover, and lipid metabolism in elderly women with osteoporosis

PURPOSE: To compare the effects of alendronate and raloxifene on lumbar bone mineral density (BMD), bone turnover, and lipid metabolism in elderly women with osteoporosis. SUBJECTS AND METHODS: One hundred twenty-two postmenopausal women with osteoporosis (mean age: 69.4 years) were randomly divided into 2 groups of 61 patients: the alendronate group and the raloxifene group. BMD of the lumbar spine, urinary level of cross-linked N-terminal telopeptides of type I collagen (NTX), and serum levels of alkaline phosphatase (ALP), total cholesterol (TC), high and low density lipoprotein cholesterols (LDL-C and HDL-C, respectively), and triglycerides (TG) were measured during the 12-month-treatment period. RESULTS: The trial in 50 patients in the alendronate group and 52 patients in the raloxifene group could be completed. Both alendronate and raloxifene increased lumbar BMD (+8.0% and +2.4% at 12 months, respectively), followed by reductions of urinary NTX level and serum ALP level; however, the effects of alendronate were more pronounced than those of raloxifene. Only raloxifene reduced the serum levels of TC and LDL-C (-3.9% and -7.7% at 12 months, respectively), without any significant effect on the serum HDL-C and TG levels. CONCLUSION: The present study confirmed the efficacy of alendronate greater than raloxifene in increasing lumbar BMD through its effect on marked reduction of the bone turnover more than by raloxifene, and some beneficial effects of raloxifene on lipid metabolism in elderly women with osteoporosis.     

中西药联合使用结合保守治疗对老年骨质疏松性肱骨近端骨折影响的临床研究

目的分析中西药联合使用结合保守治疗在老年骨质疏松性肱骨近端骨折患者中的疗效。方法选取老年骨质疏松性肱骨近端骨折患者100例,将100例患者随机分为治疗组(n=50)和对照组(n=50)。所有患者均给予手法复位结合可调节上肢外展架治疗,治疗组在此基础上给予阿仑膦酸钠联合仙灵骨葆,为期12个月。比较治疗前后患者骨折愈合时间、并发症发生情况,骨代谢和骨密度等指标改变。结果治疗后1个月、3个月、6个月及12个月时两组患者疼痛情况比较,治疗组疼痛数字分级法(numeric pain intensity scale,NPIS)评分明显低于对照组(P0.05),随访12个月时治疗组患者肩关节功能恢复情况明显优于对照组(P0.05),治疗组术后并发症发生率明显低于对照组(P0.05),治疗组骨折愈合时间明显短于对照组(P0.05)。治疗6个月、12个月后,治疗组患者腰椎正位(L2~4)、左股骨颈的骨密度和血清骨钙素水平均明显高于对照组,而治疗组血清β-CTX水平较对照组明显降低,差异均有统计学意义(P0.05);治疗6个月、12个月后,两组患者血清N端中段骨钙素水平与治疗前的差异无统计学意义(P0.05)。结论阿仑膦酸钠联合仙灵骨葆治疗对老年骨质疏松性肱骨近端骨折外展架固定后安全有效,能够有效减轻患者疼痛,加速骨折愈合,改善患者肩关节功能,降低治疗后并发症的发生率。     

阿仑膦酸钠与鲑鱼降钙素对腰椎后路椎间融合术后疗效的比较研究

【摘要】目的 探讨阿仑膦酸钠与鲑鱼降钙素对椎间融合临床疗效的差异。方法 回顾性分析我科自2010年9月~2012年8月间治疗168例腰椎管狭窄合并腰椎间盘突出症患者资料,所有患者均行椎弓根螺钉固定、后路椎间融合术。依照PLIF术后用药的不同将患者机分为阿仑膦酸钠组(A组,n=51),鲑鱼降钙素组(B组,n=52)和对照组(C组,n=65,不使用任何抗骨质疏松及补钙药物)。比较患者的基本情况、临床效果和影像学结果(融合率和手术节段椎间隙高度的变化)。结果 术后随访半年~2年1个月,平均18个月。A、B、C组三组的优良率分别为88.2%、88.5%、61.5%,A、B组优良率均较对照组明显提高,但A、B组间优良率差异无显著性意义;A组和B组在手术时间、失血量以及住院时间上差异也无显著性。术后1年随访时融合率A组为84.3%,B组84.6%,C组53.8%,A、B组均高于C组,A、B组间比较差异无显著性意义。三组患者术后椎间隙高度均有不同程度的丢失,A组1.1 (0.6~1.9)mm、B组1.1 (0.8~2.1) mm,两组间比较差异无显著性意义,但A、B组椎间隙高度丢失程度均较对照组C组4.0 (1.9~4.9) mm明显降低。结论 腰椎后路椎间融合术(PLIF)术后规范使用阿仑膦酸钠或鲑鱼降钙素能够获得令人满意的临床效果,具有较高的椎间植骨融合率及较少的椎间隙高度丢失。     

骨小梁Micro—CT检测评价阿仑膦酸钠预防大鼠激素性股骨头坏死的效果

目的探讨阿仑膦酸钠预防大鼠激素性股骨头坏死的疗效。方法将200只sD大鼠随机分成两组,其中实验组（A组）140只,对照组（B组）60只。对实验组大鼠给予连续灌喂阿仑膦酸钠溶液干预,对照组大鼠给予连续灌喂生理盐水,两组大鼠同时给予灌喂阿莫西林预防感染,2周后对所有大鼠均连续腹腔内注射大剂量甲级强的松龙4周。注射结束后2、4、8、12周分别处死等量大鼠进行micro—CT检测和HE染色评估造模成功率。结果计算骨小梁空骨陷窝率得出A组大鼠通过组织病理学检测显示造模成功率约30％,而B组造模成功率达50％。A组大鼠在干预开始后2、4、8、12周股骨头标本行Mirco—CT检查显示骨小梁平均间距分别为0．766、0．761、0．753、0．501um,骨小梁平均数目分别为6．146、6．159、6．194、6．723,骨小梁平均厚度为0．097、0．101、0．109、0．138um,组内2、4、8周取材检测结果无明显统计学意义（F值分别为1．670,452．719,1．737,P值均〉0．05）;但是12周时取材检测结果和前次检测结果之间存在显著差异,结果具有统计学意义（F值分别为26．178,58719．299,23．023,P〈0．05）;B组于12周时micro—CT检测结果提示骨小梁平均间距、平均数目、平均厚度分别为0．765um、6．141、0．093um,与干预组12周时Micro-CT结果均具有显著统计学意义（,值分别为13．498,22．557,52．072,P〈0．05）。结论阿仑膦酸钠预防大鼠早期激素性股骨头坏死具有一定作用,但是预防人体股骨头坏死是否具有相同疗效尚需进行多中心临床研究。     

五加补骨方及阿仑膦酸钠对模拟失重大鼠骨丢失干预比较

目的:比较五加补骨方及阿仑膦酸钠对3周尾吊模拟失重大鼠前后肢骨胳及肌肉丢失的干预作用.方法:自2009年3月至5月,6周龄雄性Wistar大鼠40只,按体重用随机区组法分为:五加补骨方组(HUC)、阿仑膦酸钠组(HUA)、空白组(CON)、模型组(HU),每组10只.动物实验周期为4周,HUC组全程给予五加补骨方(含刺五加、熟地黄、怀牛膝、牡蛎等)水煎剂,按体重10 ml/kg剂量每日灌胃1次,药液浓度0.704 g/ml;HUA组全程给定量阿仑膦酸钠片溶解混悬剂灌胃,按体重10 ml/kg剂量每周灌胃1次,药液浓度0.9 mg/ml;CON组和HU组均以上述方法全程给予蒸馏水.自第2周始,HU、HUC、HUA组均以尾部悬吊模拟失重3周.第4周末处死大鼠,分别测量血清钙、磷含量及碱性磷酸酶活性(ALP),肱骨和股骨骨密度(BMD)、肱骨和胫骨生物力学性能(biomechanical property)以及肱二头肌和腓肠肌重量指数.结果:与CON组比较,HU组血清Ca显著升高(P＜0.05),后肢BMD、力学性能及肌肉指数均显著降低(P＜0.01);与CON组比较,HUA组血清Ca显著升高(P＜0.05).HUC组血清ALP显著高于其他3组(P＜0.01).与HU组比较,HUC组及HUA组股骨BMD均显著升高,胫骨最大载荷、最大桡度及弹性载荷均有升高趋势;与HU组相比,HUC组及HUA组腓肠肌萎缩分别缓解12.5%和50%(P＞0.05),肱骨BMD均无显著变化,而HUA组肱骨最大桡度(P＜0.01)及弹性桡度(P＜0.05)均较HU组有显著降低.结论:中药复方和阿仑膦酸钠均可有效抑制模拟失重造成的后肢骨及肌肉丢失,改善其力学结构.中药复方在缓解上肢力学性能改变方面表现出一定优势.在治疗航天失重骨丢失类疾病上,五加补骨方与阿仑膦酸钠效果相当.     

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。     

载阿仑膦酸钠骨水泥抑制钛磨屑诱导的假体周围骨溶解

目的 比较载阿仑膦酸钠丙烯酸骨水泥与皮下注射阿仑膦酸钠抑制钛磨眉诱导的骨溶解的效果.方法 48只成年雄性新西兰兔随机均分为无钛磨屑且无阿仑膦酸钠组(A组),有钛磨屑注射且无阿仑膦酸钠组(B组),钛磨屑分别注射0.1%、0.5%、1.0%载阿仑膦酸钠丙烯酸骨水泥组(C、I)、E组),钛磨屑注射且皮下手射阿仑膦酸钠组(F组),每组8只.将载阿仑膦酸钠骨水泥植入兔股骨远端.制备磨屑诱导骨溶解动物模型.术后8周对股骨行组织形态学分析、骨密度(bone mineral density,BMD)测定及界面力学测试结果 B组假体周围可见明显的骨溶解,而C、D、E、F组骨溶解明显少于B组.B组假体周围BMD和骨-骨水泥界面抗剪强度分别较A组下降17%和56%;D组假体周围BMD和界面抗剪强度较B组分别增加29%和62%;E组假体周围BMD和界画抗剪强度较B组分别增加37%和29%;F组假体周围BMD和界面抗剪强度较B组分别增加51%和69%;C组、D组、E组分别与F组比较,假体周围BMD和界面抗剪强度的差异均无统计学意义.结论 载阿仑瞵酸钠丙烯酸骨水泥与皮下注射阿仑瞵酸钠均可在一定程度上抑制磨屑诱导的骨吸收,增强界画抗剪强度.