联合应用阿仑膦酸钠及替勃龙对围绝经期及绝经后妇女骨质疏松症患者血清MMP-2、9及骨转换标志物的影响

目的探讨阿仑膦酸钠及替勃龙对更年期妇女骨质疏松症患者MMP-2、9及骨转换的影响。方法选择2009年7月～2010年12月在笔者医院更年期门诊经BDM测量诊断为骨量减少或骨质疏松的围绝经期及绝经后年龄在46～75岁之间的86例女性,随机分为实验组46例,口服阿仑膦酸钠片70mg每周1次+替勃龙1.25mg/d+服用复方氨基酸鳌合钙口服1000mg/d;对照组40例,口服氨基酸螯合钙1000mg/d。两组妇女均连续服药48周。治疗前、后采用酶联免疫法检测血清基质金属蛋白酶-2(MMP-2)和基质金属蛋白酶-9(MMP-9)、骨碱性磷酸酶(BALP)、1型胶原C端肽(CTX)、25羟维生素D3[25(OH)D3]。结果 86例中共9例(10.47%)未完成研究,具体原因如下:试验组退出5例(上腹部隐痛不适,烧灼感3例,恐癌2例)。对照组4例(失访1例,自动退出3例),退出病例未纳入统计,退出病例未纳入统计。①骨代谢指标:BALP及CTX两组治疗后均较治疗前显著下降,差异有统计学意义(P<0.05);25(OH)D3治疗后实验组较治疗前显著上升,对照组较治疗前显著下降,差异有统计学意义(P<0.05);②MMP:MMP-2及MMP-9治疗后实验组较治疗前显著下降,对照组较治疗前显著上升,差异有统计学意义(P<0.05)。结论阿仑膦酸钠及替勃龙可用于OP的治疗,可降低MMP-2、9及骨转换,对治疗骨质疏松症有理论依据和临床意义。

Influence of Alendronate and Tibolone Combinaton on The Levels of Matrix Metalloproteinase-2,9 and Bone Turnover Marker in Treating Osteoporosis Menopsuse Women

Objective To observe the influences of alendronate and tibolone combination treatment in osteoporosis menopause women on the levels of matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9) and bone turnover markers.Methods Eighty-six perimenopause or postmenopause women who were diagnosed as osteopenia or osteoporosis by BDM test from July 2009 to December 2010 were studied and divided into 2 groups randomly.Forty-six women,as the experimental group,oraly took the bisphosphonates 70mg/w + Tibolone 1.25mg+Osteoform 1000mg/d for 48 weeks,while in the control group,only Osteoform 1000mg/d was taken.MMP-2,9 as well as biochemical bone turnover markers such as bone alkaline phosphatase(BALP),cross linked clelopeptide of type I collagen(CTX) and 25-hydroxychole calciferol [25(OH)D3] were measured before and after the treatment.Results The level of BALP and CTX decreased significantly after the treatment in both groups(P<0.05).The level of 25(OH)D3 in the test group was significantly higher after the treatment,while in the control,it had a significant decrease(P<0.05).Compared to the level of MMP-2 and MMP-9 before the treatment,those in the test group decreased significantly,and increased in the control,(P<0.05)Conclusion Combined use of alendronate and tibolone can lower the level of MMP-2,MMP-9,and bone turnover markers.And base on this theory,it may be a clinical useful therapy for osteoporosis.Both of them can decrease the level of MMP-2、9 and bone turnover marker and are good for the theory and experiment of osteoporosis.