阿仑膦酸钠对绝经后骨质疏松或骨量减少妇女骨密度影响的研究

目的观察阿仑膦酸钠（福善关）治疗绝经后骨质疏松或骨量减少妇女1年，其腰椎及股骨近端骨密度（BMD）的变化，为该药的临床应用提供依据。方法选取2004年1月-2009年年4月接受阿仑膦酸钠治疗的45～80岁骨质疏松或骨量减少妇女147例为研究对象，均为原发性骨质疏松或骨量减少。147例妇女服用阿仑膦酸钠70mg，1次／周，疗程至少1年。按绝经年限分成两组：绝经年限≤10年者56例，绝经年限〉10年者91例。使用双能X线吸收仪测定所有妇女治疗前后腰椎（L1～4）、股骨颈（neck）、大转子（troch）及全髋（total hip）部位的BMD。结果阿仑膦酸钠治疗1年后腰椎BMD平均增加2．42％～3．62％，股骨近端各部位BMD与治疗前比较提高1．65％～3．01％。治疗1年后，显效率为72．8％，有效率为10．2％，总有效率为83．0％。绝经年限≤10年和绝经年限〉10年者比较各部位BMD增加百分率间差异无统计学意义（P〉0．05）。结论阿仑膦酸钠治疗1年能显著增加绝经后骨质疏松或骨量减少妇女的腰椎和股骨近端各部位的BMD，无论绝经年限长短BMD均显著增加。建议临床选用阿仑膦酸钠治疗，且首次治疗疗程至少1年。

Effect of Alendronate on Bone Mass in Women with Postmenopausal Osteoporosis or Osteopenia

Objective To investigate the changes of the bone mineral density (BMD) of lumbar spine and proximal femur in women with postmenopausal osteoporosis (PMOP) or osteopenia who received alendronate (fosamax).Methods A total of 147 women with primary PMOP or osteopenia (over the age of 45) receiving alendronate (70 mg,once/week,at least 1 year) from 2004 to 2009 were chosen as subjects.All women were divided according to duration of menopause into groups A (≤10 years,n=56) and B (＞10 years,n=91).The BMD of lumbar (L-1-4),femoral neck,greater trochanter and total hip was determined by dual-energy X-ray absorptiometry in all women before treatment and after.Results After 1-year alendronate treatment,BMD of lumbar increased by an average of 2.42%～3.62%,and that of all parts of proximal femur by 1.65%～3.01%.The rates of excellence,effect and total effect were 72.8%,10.2%,83.0%,respectively.There was not significant difference in increasing percentage in BMD between 2 groups (P＞0.05).Conclusion One-year alendronate treatment can increase significantly BMD of lumbar and proximal femur in women with PMOP or osteopenia,regardless of the length of post-menopausal years.Alendronate treatment is proposed in clinic,and its first treatment should last at least 1 year.