阿仑膦酸钠对绝经后骨质疏松合并骨关节炎患者骨强度的影响

目的探讨阿仑膦酸钠对绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)合并骨关节炎(osteoarthritis,OA)患者骨强度的影响。方法选取华北理工大学附属医院骨质疏松门诊2016年5月至2019年10月诊治的144例患者,根据其诊断分为OP+OA组(73例)和OP组(71例)。两组患者口服阿仑膦酸钠(1次/周),连续治疗12个月。比较两组患者治疗前后股骨颈截面面积(CSA)、股骨颈截面转动力矩(CSMI)、股骨颈截面模量(Z)、股骨颈皮质厚度(CT)、股骨颈屈曲应力比(BR)、骨密度、疼痛视觉模拟评分(VAS)、Lysholm膝关节评分、生化指标变化。结果两组患者治疗后CSA、CSMI、Z、腰椎和股骨颈骨密度、Lysholm膝关节评分高于治疗前(P<0.05),而在治疗12个月后OP+OA组患者腰椎、股骨颈骨密度高于OP组(P<0.05)。两组患者治疗后BR、VAS评分低于治疗前(P<0.05),而在治疗后12个月OP+OA组患者BR、VAS评分低于OP组(P<0.05)。结论阿仑膦酸钠应用于绝经后骨质疏松合并骨关节炎患者治疗,不仅可以提高骨密度、改善关节症状,还能提高髋部骨强度。

Clinical effect of alendronate on bone strength in postmenopausal women with osteoporosis and osteoarthritis

Objective To investigate the effect of alendronate on bone strength in postmenopausal osteoporosis (OP) patients with osteoarthritis (OA). Methods One hundred and forty-four patients diagnosed and treated in osteoporosis clinic of the Affiliated Hospital of North China University of Science and Technology from May 2016 to October 2019 were selected. They were divided into OP+OA group (73 cases) and OP group (71 cases) according to the diagnosis. The patients in the two groups received alendronate once a week for 12 months. The changes of CSA, CSMI, Z, CT, BR, BMD, VAS, Lysholm knee joint scores, and biochemical indexes were compared before and after the treatment. Results After the treatment, CSA, CSMI, Z, BMD of the lumbar vertebrae and femoral neck, and Lysholm knee joint scores in the two groups were higher than those before the treatment (P<0.05). BMD of the lumbar vertebrae and femoral neck in OP+OA group was higher than that in OP group after 12 months of the treatment (P<0.05). After the treatment, BR and VAS were lower than those before treatment in the two groups (P<0.05). BR and VAS in the OP+OA group were lower than those in the OP group after 12 months of the treatment (P<0.05). Conclusion Alendronate not only improves BMD and relieves joint symptoms, but also increases bone strength of the hip.