阿仑磷酸钠对糖尿病骨质疏松症患者骨代谢的影响

目的探究阿仑磷酸钠对糖尿病骨质疏松症(DOP)患者骨代谢的影响。方法前瞻性收集2017年12月至2018年12月秦皇岛军工医院收治的108例DOP患者,随机分为对照组(54例)和阿仑磷酸钠组(54例),所有患者均给予常规对症及降糖治疗,阿仑磷酸钠组在此基础上给予阿仑膦酸钠片。治疗2个月后,观察并比较两组患者的骨代谢指标、骨密度(BMD)、血生化指标和临床疗效。结果治疗后,对照组的血清骨代谢指标骨特异型碱性磷酸酶(BAP)、骨钙素(BGP)、人抗酒石酸酸性磷酸酶5b(TRAP-5b)水平分别为(7.52±3.20)μg/L、(6.24±2.22)U/L、(3.30±1.13)ng/ml,阿仑磷酸钠组分别为(9.41±3.32)μg/L、(7.73±2.34)U/L、(2.45±1.18)ng/ml;治疗后,两组BAP和BGP水平较治疗前升高(t=4.670,t=6.120,P<0.05),组间比较,阿仑磷酸钠组高于对照组,差异有统计学意义(t=3.010,t=3.390,P<0.01);两组TRAP-5b(t=4.780,t=5.620,P<0.05)水平较治疗前下降,组间比较,阿仑磷酸钠组低于对照组,差异有统计学意义(t=3.820,P<0.01)。治疗后,对照组的腰椎和股骨颈的BMD分别为(0.82±0.06)g/cm2、(0.74±0.05)g/cm2,阿仑磷酸钠组分别为(0.91±0.04)g/cm2、(0.83±0.08)g/cm2,两组腰椎和股骨颈BMD(t=3.840,t=3.760,P<0.05)水平较治疗前均升高,组间比较,阿仑磷酸钠组高于对照组(t分别=9.170和7.010,P<0.05)。治疗后,对照组空腹血糖(FBG)、餐后2 h血糖(2 hBG)、糖化血红蛋白(HbA1c)水平分别为(7.06±0.29)mmol/L、(8.02±3.17)mmol/L、(6.21±0.46)%,对照组FBG、2 hBG、HbA1c水平分别为(8.12±0.33)mmol/L、(9.98±0.54)mmol/L、(7.56±0.67)%,两组比较,阿仑磷酸钠组低于对照组,差异有统计学意义(t=17.730,4.480,12.210,P<0.01)。阿仑磷酸钠组总有效率(90.74%)高于对照组(79.63%,P<0.05)。结论阿仑磷酸钠治疗DOP患者疗效显著,可有效改善其骨代谢,促进BMD水平增加,值得临床加以推广与应用。

Effects on bone metabolism in patients with diabetic osteoporosis using alendronate

ObjectiveTo explore the effect on bone metabolism in patients with diabetic osteoporosis (DOP) using alendronate. Methods108 patients with DOP hospitalized in our hospital from December 2017 to December 2018 were randomly divided into the control group (54 cases) and the alendronate group (54 cases). All patients were treated with routine treatment and alendronate group was given alendronate tablets on this basis. After 2 months treatment, the bone metabolism index, bone mineral density (BMD), blood biochemical index and clinical efficacy were observed and compared between the two groups. ResultsAfter treatment, the serum bone metabolism indexes bone specific alkaline phosphatase (BAP), osteocalcin (BGP) and human tartrate-resistant acid phosphatase 5b (TRAP-5b) in the control group were (7.52±3.20) μg/L, (6.24±2.22) U/L, (3.30±1.13) ng/ml, respectively, and the alendronate group was (9.41±3.32) μg/L, (7.73±2.34) U/L, (2.45±1.18) ng/ml, respectively. After treatment, the levels of BAP (t=4.670, P<0.05) and BGP (t=6.120, P<0.05) in the two groups were higher than those before treatment. Compared with the control group, the levels of sodium alendronate group were significantly higher than those in the control group, with statistically significant differences (t=3.010 and 3.390, P<0.01, respectively). Trap-5b (t= 4.780 and 5.620, P<0.05, respectively) level of the two groups decreased compared with that before treatment. Compared with the control group, sodium alendronate group was significantly lower than the control group, and the difference was statistically significant (t=3.820, P<0.01). There was no significant difference in bone metabolism before and after treatment in the control group (P>0.05). After treatment, the BMD of lumbar spine and femoral neck in the control group were (0.82±0.06) g/cm² and (0.74±0.05) g/cm², respectively, and those in the alenphosphate group were (0.91±0.04) g/cm² and (0.83±0.08) g/cm², respectively. BMD levels in lumbar spine and femoral neck (t=3.840 and 3.760, P<0.05, respectively) were higher in both groups than before treatment, and the alendronate group was higher than the control group (t=9.170 and 7.010, P<0.05, respectively). After treatment, fasting blood glucose (FBG), postprandial blood glucose (2 hBG), glycadified hemoglobin (HbA1c) levels in the control group were (7.06±0.29) mmol/L, (8.02±3.17) mmol/L, (6.21±0.46)%, respectively. The FBG, 2 hBG, and HbA1c levels in the control group were (8.12±0.33) mmol/L, (9.98±0.54) mmol/L, and (7.56±0.67)%, respectively. The comparison between the two groups showed that the alenophosphate group was significantly lower than the control group, with statistically significant differences (t=17.730, 4.480, 12.210, P<0.01). The total effective rate was 90.74% significantly higher than 79.63% in the control group (P<0.05). ConclusionAlendronate combined with control was effective in the treatment of patients with DOP, and it can improve bone metabolism and increase the level of BMD, which was worthy of clinical promotion and application.