唑来膦酸治疗糖尿病性骨质疏松68例

目的：探讨唑来膦酸治疗糖尿病性骨质疏松（DO）的疗效。方法选取68例接受4 mg 唑来膦酸治疗的 DO 患者，观察其不良反应，对比治疗前后骨密度、血清碱性磷酸酶（ALP）、钙（Ca）、降钙素（CT）、1，25-二羟维生素 D（VD）、骨钙素（BGP）、1型前胶原羧基端前肽（PICP）及疼痛视觉模拟评分（VSA）变化。结果68例患者中出现的不良反应主要有发热4例，流感样症状12例，胃肠道症状6例，血液系统症状5例，神经系统症状3例，注射部位局部症状4例。治疗后各点骨密度值较治疗前均显著升高（ P ﹤0.05），且 VAS 评分治疗后显著降低（ P ﹤0.01）。血清 ALP 及 Ca 在治疗后无显著变化，而 CT，VD，BGP，PICP 均较治疗前显著升高（ P ﹤0.05）。结论唑来膦酸能增加 DO 患者的骨吸收，提高骨密度，缓解患者疼痛，是治疗 DO 安全、有效的药物。

Efficacy of Zoledronic Acid in Treating Diabetic Osteoporosis in 68 Cases

Objective To investigate the efficacy of zoledronic acid in treating diabetic osteoporosis（DO）. Methods 68 patients with DO treated by zoledronic acid 4 mg were selected. The adverse reactions of zoledronic acid were observed. The changes of bone density, the levels of serum alkaline phosphatase（ALP）, calcium（Ca）, calcitonin（CT）, 1, 25 - dioxy - vitamin D（VD）, osteocalcin（BGP）, procollagen type I carboxy - terminal peptide（PICP） and score of the pain degree scale（VAS） were compared between before and after treatment. Results The adverse reactions occurred in 68 cases mainly included fever 4 cases, influenza - like symptoms 12 cases, gastrointestinal symptom 6 cases, hematological symptom 5 cases, nerve system symptom 3 cases and local symptom in the injection site 4 cases. The bone density at various points after treatment was significantly increased compared with before treatment（ P ﹤ 0. 05） and the VAS scores after treatment were significantly decreased（ P ﹤ 0. 01）. The levels of serum ALP and Ca after treatment had no obvious change, but CT, VD, BGP and PICP after treatment were increased significantly compared with before treatment（ P ﹤ 0. 05）. Conclusion Zoledronic acid can increase the bone resorption, enhance the bone density and relieve the pain degree in the DO patients, which is an effective and safe drug for treating DO.