唑来膦酸结合钙尔奇对老年脑梗死合并骨质疏松症 患者疗效影响的临床研究

Clinical study of the effect of zoledronic acid combined with calcium on cerebral infarction with osteoporosis in elder people.

Objective To study the changes of bone mineral density,bone biochemistry,and transformation in elderly patients with cerebral infarction and osteoporosis after the treatment with zoledronic acid and calcium. Methods 98 patients with cerebral infarction and osteoporosis were divided into treatment group （n=49） and control group （n=49） according to a random number table. Patients in the control group was treated with calcium and in the treatment group was treated with zoledronic acid in combination with calcium for 24 weeks. After the treatment,bone mineral density of the lumbar vertebrae 1-4(L1-4),femoral neck,and the levels of blood calcium （Ca）,blood phosphorus （P）,25-hydroxyvitamin D [25（OH） D3],parathyroid hormone （PTH）,osteocalcin （OC）,type 1 collagen carboxy terminal peptide（β-CTX）,type 1 procollagen amino terminal peptide（P1 NP）,and bone alkaline phosphatase （BALP） were measured.The adverse effect in patients of the two groups were recorded. Results After 6-month treatment,the bone mineral density of the lumbar vertebrae 1-4(L1-4) and femoral neck were significantly higher than those in the control group （P<0.05）. Six months after treatment,the serum PTH,OC,P1 NP,and BALP were significantly higher than those before treatment （P<0.05）,while 25（OH） D3 and β-CTX were significantly lower than those before treatment （P<0.05）. There was no significant difference in the incidence of adverse drug reactions between the two groups（P>0.05）. Conclusion Zoledronic acid combined with calcium improves bone mineral density in elderly patients with cerebral infarction and osteoporosis,and improves bone biochemistry and metabolic status. [ABSTRACT FROM AUTHOR]

目的研究老年脑梗死合并骨质疏松症患者应用唑来膦酸结合钙尔奇对患者骨密度、生化与骨代谢相关指标的影响。方法 98例脑梗死急性期后伴肢体瘫痪合并骨质疏松症患者,按随机数字表法将其分为治疗组（n=49）及对照组（n=49）。对照组给予钙尔奇治疗,治疗组给予唑来膦酸联合钙尔奇治疗,为期6个月。检测治疗后两组患者腰椎1-4(L1-4)、股骨颈骨密度及血钙（Ca）、血磷（P）、25羟基维生素D[25（OH）D3]、甲状旁腺素（parathyroid hormone,PTH）、骨钙素（osteocalcin,OC）、1型胶原羧基末端肽（type 1 collagen carboxyl terminal peptide,β-CTX）、1型前胶原氨基端肽（type 1 procollagen amino terminal peptide,P1NP）、骨源性碱性磷酸酶（bone alkaline phosphatase,BALP）水平的变化情况。记录两组患者药物的不良反应。结果治疗后6个月,治疗组腰椎14(L1-4)、股骨颈骨密度均显著高于同时期对照组（P<0.05）;治疗后6个月,治疗组患者血清PTH、OC、P1NP、BALP均显著高于治疗前（P<0.05）,而25（OH）D3及β-CTX均显著低于治疗前（P<0.05）,而Ca、P差异无统计学意义（P>0.05）。两组药品不良反应发生率比较,差异无统计学意义（P>0.05）。结论唑来膦酸联合钙剂可提升老年脑梗死患者骨密度,改善骨代谢状态,可以安全有效地防治老年脑梗死骨质疏松症。 [ABSTRACT FROM AUTHOR]

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