重组人甲状旁腺素（1-34）治疗原发性骨质疏松症疗效观察

目的 观察对比重组人甲状旁腺素（1-34）PTH（1-34）]和降钙素对原发性骨质疏松症的疗效.方法 将20例原发性骨质疏松症患者随机分为试验组和对照组.试验组皮下注射PTH（1-34）20μg,每天1次;对照组肌肉注射降钙素20 IU,每周1次,两组均每日口服钙尔奇D 600mg,连续治疗6个月.所有患者于治疗前后枪测腰椎（L2～L4）、股骨颈骨密度、血钙及血清骨特异性碱性磷酸酶（BSAP）、血清I型胶原交基C端肽（CTX）、PTH等指标及观察有无不良反应.结果 治疗后PTH组和降钙素组腰椎（L2～L4）骨密度变化较治疗前均有明显增加,且有统计学意义.治疗后两组股骨颈骨密度变化较治疗前无明显改善（P〉0.05）,两组间比较无明显差异（P〉0.05）.PTH组BSAP变化值明显高于对照组,两组间比较差异有统计学意义（P〈0.01）;两组治疗后血、尿常规、肝、肾功能均未见明显异常.结论 PTH（1-34）与降钙素都能显著提高腰椎（L2～L4）骨密度,对于原发性骨质疏松症治疗安全有效.

Therapeutic efficacy of Recombinant human parathyroid hormone PTH(1-34)on osteoporosis

Objective To observe and compare the therapeutic effects of recombinant human parathyroid hormone （1-34） FFH （ 1-34 ） ] and calcitonin for patients with osteoporosis. Methods 20 patients with osteoporosis were randomly divided into two groups：experimental group and control group. The patients in experimental group were treated with PTH （1-34） 20 μg/d by subcutaneous injection,and those in control group were treated with calcitonin 20 IU/w by intramuscular injection. All patients were given oral calcium 600 mg. All the treatments lasted for six months. Lumbar spine（ L2-4 ） and femoral neck bone mineral density （ BMD ）, serum calcium, serum bony special alkaline phosphatase （ BSAP ）, serum type I collagen cross-linked C-telopeptide（CTX） and PTH were measured in two groups before and after treatment respectively. Meanwhile, observed the presence of adverse effects. Results Both of the lumbar spine BMD（L2-4） in two groups were remarkably increased after treatment,and the two have significant differences. Changes in femoral neck BMD after treatment were not significant（ P 〉 0.05 ）. There were no significant differences between two groups（P 〉 0.05 ）. After treatment, BSAP levels were obviously increased in PTH group than calcitonin group （ P 〈 0. 01 ）. No significant difference was observed between the two groups in routine blood test, routine urinate test,hepatic and renal function panel. Conclusion Both PTH （1-34） and calcitonin treatment can increase lumbar spine（ L2-4 ） BMD in patients with osteoporosis, and treatment osteoporosis safe and effective.