3种方案治疗绝经后骨质疏松疗效观察

目的:探讨3种不同方案治疗绝经后妇女骨质疏松的临床疗效。方法:将绝经后伴骨量减少妇女110例,随机分成3组。A组36例,钙尔奇D 1 200 mg/d+骨化三醇0.25μg/bid;B组39例,钙尔奇D 1 200 mg/d+骨化三醇0.25μg/bid+替勃龙1.25 mg/d;C组35例,钙尔奇D 1200 mg/d+骨化三醇0.25μg/bid+盐酸雷洛昔芬60 mg/d。3组妇女连续治疗1年。治疗前后测定腰椎第1~4节(L1~4)及股骨骨密度(BMD);同时检测血清骨碱性磷酸酶(BALP)及血清Ⅰ型前胶原肽(CTX)评价骨代谢指标。结果:①骨痛症状改善。3组妇女治疗1年后骨痛症状均得到改善,A、B、C组改善率分别为83%、92%、95%。②骨密度升高。3组妇女治疗后骨密度明显升高,分别与治疗前比较,差异均有统计学意义(P<0.05);治疗后1年B、C组妇女BMD均较A组显著升高,差异有统计学意义(P<0.01),但B、C两组间比较,差异无统计学意义(P>0.05)。③骨代谢指标。3组妇女治疗后BALP及CTX水平均较治疗前降低,差异有统计学意义(P<0.05);3组间比较,治疗1年后血清CTX水平,B组较C组显著下降,差异有统计学意义(P<0.01),B组较A组下降更为显著,差异有统计学意义(P<0.000 1)。结论:3种方案均可用于骨质疏松的治疗,降低骨转换、增加BMD、减少骨吸收。

Effects of three regimens in the treatment of osteoporosis in postmenopausal women

Objective:To evaluate clinical efficacy of three regimens in the treatment of osteoporosis of postmenopausal women.Methods:110 postmenopausal women with low bone mineral density(BMD) or osteoporosis treated in our hospital were divided into three groups.36 women in group A managed by caltrate D600 1 200 mg/d + calcijex 0.25 μg/bid orally;39 women in group B managed by caltrate D600 1 200 mg/d+ calcijex 0.25 μg /bid + tibolone 1.25 mg/d orally;35 women in group C managed by caltrate D 600 1 200 mg/d + calcijex 0.25 μg /bid + raloxifene 60mg/d orally.After 1 year BMD on lumbar 1-4(L1-4) and femur were detected by X-ray.Bone alkaline phosphatase(BALP) and type I collagen C-telopeptides were measured as biochemical markers of bone metabolism.Results:①Pain relieve: after 1 year treatment,women in three groups improved symptom of pain significantly,the rates of pain relieve were 83% in group A,92% in group B,95% in group C.②BMD: It was shown significantly different between group B or C and group A(P<0.05),however,there was no significant different between group B and C after 1 year treatment(P>0.05).③Index of bone metabolism: BALP were showed statistical different after 1 year treatment in three groups(P<0.05).CTX was shown significantly different between group B or C and group A(P<0.01),moreover,there was significantly different between group B and A after 1 year treatment(P<0.0001).Conclusion:Those 3 regimens combination can be used in treatment of osteoporosis by decreasing bone conversion,increasing bone density,decreasing bone absorption.