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 观察重组人甲状旁腺素(1-34)PTH(1-34)]治疗前后骨密度、骨代谢指标变化，以评价该药治疗原发性骨质疏松症疗效。方法 20例原发性骨质疏松症患者皮下注射PTH(1-34) 20μg 每天1次,每日口服钙尔奇D 600mg，连续治疗6个月。所有患者于治疗前、治疗后第3月、第6月检测腰椎(L2-L4)及股骨颈骨密度、血清骨特异性碱性磷酸酶（BSAP）、血清I型胶原交基C端肽(CTX)。结果 治疗后腰椎(L2-L4)骨密度较治疗前均显著升高，差异有统计学意义（P<0.05或P<0.01）。治疗后股骨颈骨密度较治疗前无明显改善(P>0. 05)。治疗后第3月、第6月BSAP较治疗前显著升高，差异有统计学意义（P<0.01），治疗后第6月CTX较治疗前显著升高，差异有统计学意义（P<0.01）。结论 PTH(1-34)能显著提高腰椎（L2-L4）骨密度，对原发性骨质疏松症治疗有效。

The observation of therapeutic efficacy of recombinant human parathyroid hormone PTH (1-34) on primary osteoporosis

Objective To observe the changes of bone mineral density (BMD) and bone metabolic index before and after the treatment of recombinant human parathyroid hormone (1-34) PTH (1-34)], in order to evaluate the therapeutic efficacy of PTH (1-34) on primary osteoporosis. Methods Twenty patients with primary osteoporosis received a subcutaneous injection of 20 ug PTH (1-34) and an oral administration of 600 mg Caltrate D once a day, lasting for 6 months. BMD of the lumbar vertebrae (L2-4) and the femoral neck, serum bone specific alkaline phosphatase (BSAP), and serum type I collagen cross-linked C-telopeptide (CTX) were measured before and after 3-6 month of the treatment. Results BMD of L2-4 was significantly increased in both the 3nd- and 6th-month after the treatment, and the difference of results between before and after the treatment was significant (P<0.05 or P<0.01). BMD of the femoral neck did not change significantly after the treatment compared to the BMD before treatment (P>0.05). BSAP levels on the 3rd- and 6th-month after treatment were significantly higher than that before treatment, and the difference was significant (P<0.01). CTX on the 6th month after treatment obtained a significant increase and the difference was significant (P<0.01). Conclusion PTH (1-34) has a significant efficacy on primary osteoporosis with a remarkable increase of BMD of L2-4.