伊班膦酸钠可防治肾小球疾病患者糖皮质激素引起的骨密度减低

目的探讨伊班膦酸钠防治肾小球疾病患者糖皮质激素(GC)所致的骨密度减低的疗效和安全性，观察期1年。方法前瞻性自身对照研究16例骨量减少或骨质疏松患者，用强的松治疗半年后加用伊班膦酸钠，每3个月1mg，每3个月检测腰椎1～4(L1-4)和股骨近端骨密度(双能X线骨密度仪)。结果用GC治疗半年后各部位骨丢失(13．0—70．8)mg/cm^2，丢失率为1．4％～7．9％。加用伊班膦酸钠半年后L1-3和股骨粗隆骨量增加(5．2～26．2)mg／cm^2，增加率为1．0％～3．6％；L4、股骨颈和三角区继续骨丢失(0．5～6．9)mg/cm^2，丢失率0．1％～0．8％。2／16例出现能耐受的腰背部紧缩、酸沉和疼痛，48h内自行缓解。结论间断静脉用伊班磷酸钠防治肾小球疾病患者GC所致的骨密度减低有效且副作用小，耐受性好。

Effect of sodium ibandronate injection on corticosteroid-induced reduced bone mineral density in the patients with glomerular disease

Objective To investigate the efficacy and safety of ibandronate injections in treatment of corticosteroid-induced reduced bone mineral density(BMD) and osteoporosis in patients with glomerular disease. Methods In this prospective self control study, 16 patients with established osteoporosis and reduced BMD, after receiving prednison for half a year were freated with intravenoas used ibandronate (Ai-Ben),1mg 3-monthly and examined for BMD at the lumbar spines (L_1-L_4) and femoral neck by dual-energy X-ray absorptiometry every 3 months.Results After prednison therapy, the bone loss of every site was (13.0-70.8)mg/cm~2,the rate of bone loss being 1.4%-7.9%. After receiving ibandronate for half a year, the bone content of L_(1-3) and femoral trochanter increased (5.2-26.2)mg/cm~2,the increasing rate being 0.1%-0.8%,but the bone content of L_4,femoral neck and Ward's triangle continued losing (0.5-6.9)mg/cm~2,the rate of bone loss being 0.1%-0.8%. Two patients complained tolerable lumbodorsal straining pain, which remitted spontaneously within 48 hours.Conclusions Intermittent i.v. ibandronate injections are efficacious, well-tolerated, with rare side effect in treatmeut of corticosteroid-induced reduced BMD in patients with glomerular disease.