摘要
目的:探讨唑来膦酸对系统性红斑狼疮(SLE)合并骨质疏松患者骨密度(BMD)及骨代谢的影响。方法:收集2012年3月-2015年1月在我院治疗并自愿参加本研究的70例SLE合并骨质疏松患者的临床资料,按治疗方案不同分为观察组和对照组,各35例。两组患者均给予泼尼松和羟氯喹以维持治疗SLE,对照组患者在此基础上加用钙剂及骨化三醇等传统抗骨质疏松药物进行治疗;观察组患者在对照组基础上加用唑来膦酸注射液4 mg,ivgtt,滴注时间>30 min,每年1次,治疗3年。记录两组患者治疗前及治疗1年后腰椎、股骨颈、大转子和Ward’s三角区的BMD,治疗前和治疗1周及1年后血清中钙、磷、Ⅰ型胶原羧基端肽β特殊序列(β-CTx)、N端中段骨钙素(N-MID-OT)、骨特异性碱性磷酸酶(B-ALP)水平,以及治疗过程中的并发症情况。结果:两组患者治疗前上述各项指标比较,差异均无统计学意义(P>0.05)。治疗1年后,两组患者各部位BMD水平均明显提高,且观察组患者各部位BMD水平明显高于对照组,差异均有统计学意义(P<0.05)。治疗1年后,两组患者血磷、血钙水平及对照组患者血清β-CTx、N-MID-OT、B-ALP水平与治疗前比较,差异均无统计学意义(P>0.05);观察组患者血清β-CTx、N-MID-OT、B-ALP水平明显低于治疗前及对照组,差异均有统计学意义(P<0.05)。观察组与对照组患者治疗1年内骨折及股骨头坏死的发生率分别为5.71%和25.71%,差异有统计学意义(P<0.05)。结论:唑来膦酸可有效减轻SLE合并骨质疏松患者骨吸收程度,降低骨代谢率,提高BMD,减少骨折及股骨头坏死的风险。
OBJECTIVE： To explore the effects of zoledronic acid on bone mineral density （BMD） and bone metabolism in patients with systemic lupus erythematosus （SLE） complicated with osteoporosis. METHODS： Clinical information of 70 patients with SLE complicated with osteoporosis who volunteered for the study were collected from our hospital during Mar. 2012 to Jan. 2015 in our hospital. They were divided into observation group and control group according to therapy plan, with 35 cases in each group. Both groups were given prednisolone and hydroxychloroquine for maintenance treatment of SLE. Control group was additionally given traditional anti-osteoporosis agents as calcium and calcitriol. Observation group additionally received Zoledronic acid injection 4 mg, ivgtt, dripping time〉30 min, once a year, on the basis of control group for 3 years.The lumbar BMD, femoral neck BMD, large rotor BMD, Ward＇ s triangle BMD before and after 1 year of treatment, and serum levels of calcium, phosphorus, I3-CTX, N-MID and B-ALP in 2 groups before and after 1 week and 1 year of treatment were recorded as well as the complications during treatment. RESULTS： There was no statistical significance in above indexes between 2 groups before treatment （P〉 0.05）. After 1 year of treatment, BMD of those parts in 2 groups were increased significantly, and those of observation group were significantly higher than those of control group, with statistical significance （P〈0.05）. After 1 year of treatment, there was no statistical significance in serum levels of calcium, phosphorus between 2 groups and in serum levels of β-CTX, N-MID and B-ALP in control group compared to before treatment, without statistical significance （P〉0.05）. Serum levels of D-CTX, N-MID and B-ALP in observation group were significantly lower than before treatment and control group, with statistical significance （P〈0.05）. The incidence of fracture and femoral head necrosis in 2 groups were 5.71% and 25.71% within 1 year, with statistical significance （P〈0.05）. CONCLUSIONS： Zoledronic acid can effectively relieve bone absorption, reduce bone metabolism rate, increase BMD, and reduce the risk of fracture and the femoral head necrosis in patients with SLE complicated with osteoporosis.
出处
《中国药房》
CAS
北大核心
2017年第2期197-200,共4页
China Pharmacy
基金
国家自然科学基金资助项目(No.81260286)
关键词
唑来膦酸
系统性红斑狼疮
骨质疏松
骨密度
骨代谢
Zoledronic acid
Systemic lupus erythematosus
Osteoporosis
Bone mineral density
Bone metabolism
