骨质疏松性骨折药物治疗的优化方案研究

目的 探讨不同的抗骨松药物组合方案对于治疗骨质疏松性骨折患者的骨密度及新发骨折的影响,进而提出适合我国人群的既经济又有效的骨质疏松症规范化的防治方案.方法 240例骨质疏松性骨折患者随机被分为：单纯钙剂组、钙＋骨化三醇组、钙＋降钙素组、钙＋骨化三醇＋降钙素组等4组进行药物治疗观察1年.观察药物治疗期间骨密度、再发骨折发生情况.结果 共有2例新发骨折发生,三者联合用药组用药前后骨密度的改善最为明显,虽然其在脊柱骨密度方面提高较其他两组大,但差异无显著性（P＞0.05）,而在股骨颈部骨密度提高较其他两组却差异有非常显著性（P＜0.001）.结论 对于老年骨质疏松性骨折患者的抗骨质疏松性药物的治疗可以提高骨密度,降低新骨折的发生率.联合用药对提高骨密度优于单一用药.本研究期间只有两例发生再骨折可能缘于病例样本量少和随访时间较短有关.

A study of optimal project of drugs for treatment of osteoporotic fracture

Objective To study the re-fracture rate and the changes of BMD in spine and hip after treatment by anti-osteoporotic drugs among the different drug-combined groups. Methods 240 cases of osteoporotic fracture patients were randomly divided into four groups which were treated with calcium, calcium+calcitrioal, calcium+calcitonion, and calcium+calcitonion+calcitrioal for one year to observe the changes of BMD between spine and hip by DEXA and re-fracture rate by X-ray. Results The BMD increased more significantly in the calcium+calcitonion+calcitrioal group compared with the other groups (P<0.05). Conclusions The anti-osteoporotic drugs of calcitonion and calcitrioal can increase the BMD of osteoporotic fracture patients and the combined use of anti-osteoporotic drugs was more efficient than the sole use of one kind of drug.