發(fā)布時間：2018-04-05 20:08

  本文選題：唑來膦酸　切入點：系統(tǒng)性紅斑狼瘡　出處：《中國藥房》2017年02期

【摘要】：目的:探討唑來膦酸對系統(tǒng)性紅斑狼瘡(SLE)合并骨質(zhì)疏松患者骨密度(BMD)及骨代謝的影響。方法:收集2012年3月-2015年1月在我院治療并自愿參加本研究的70例SLE合并骨質(zhì)疏松患者的臨床資料,按治療方案不同分為觀察組和對照組,各35例。兩組患者均給予潑尼松和羥氯喹以維持治療SLE,對照組患者在此基礎(chǔ)上加用鈣劑及骨化三醇等傳統(tǒng)抗骨質(zhì)疏松藥物進(jìn)行治療;觀察組患者在對照組基礎(chǔ)上加用唑來膦酸注射液4 mg,ivgtt,滴注時間30 min,每年1次,治療3年。記錄兩組患者治療前及治療1年后腰椎、股骨頸、大轉(zhuǎn)子和Ward’s三角區(qū)的BMD,治療前和治療1周及1年后血清中鈣、磷、Ⅰ型膠原羧基端肽β特殊序列(β-CTx)、N端中段骨鈣素(N-MID-OT)、骨特異性堿性磷酸酶(B-ALP)水平,以及治療過程中的并發(fā)癥情況。結(jié)果:兩組患者治療前上述各項指標(biāo)比較,差異均無統(tǒng)計學(xué)意義(P0.05)。治療1年后,兩組患者各部位BMD水平均明顯提高,且觀察組患者各部位BMD水平明顯高于對照組,差異均有統(tǒng)計學(xué)意義(P0.05)。治療1年后,兩組患者血磷、血鈣水平及對照組患者血清β-CTx、N-MID-OT、B-ALP水平與治療前比較,差異均無統(tǒng)計學(xué)意義(P0.05);觀察組患者血清β-CTx、N-MID-OT、B-ALP水平明顯低于治療前及對照組,差異均有統(tǒng)計學(xué)意義(P0.05)。觀察組與對照組患者治療1年內(nèi)骨折及股骨頭壞死的發(fā)生率分別為5.71%和25.71%,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:唑來膦酸可有效減輕SLE合并骨質(zhì)疏松患者骨吸收程度,降低骨代謝率,提高BMD,減少骨折及股骨頭壞死的風(fēng)險。
[Abstract]:Objective: to investigate the effect of zoledronic acid on bone mineral density (BMD) and bone metabolism in patients with systemic lupus erythematosus (SLE) and osteoporosis.Methods: the clinical data of 70 patients with SLE complicated with osteoporosis who were treated in our hospital from March 2012 to January 2015 were collected and divided into observation group (35 cases) and control group (35 cases).Both groups were treated with prednisone and hydroxychloroquine to maintain the treatment of SLE.The patients in the control group were treated with traditional anti-osteoporosis drugs such as calcium and ossifying triol.Patients in the observation group were treated with zoledronic acid injection 4 mg / g iv gtt for 30 minutes once a year for 3 years.BMDs of lumbar spine, femoral neck, greater trochanter and Ward's triangle were recorded before treatment and 1 year after treatment. Serum calcium and phosphorus were recorded before treatment and 1 week and 1 year after treatment.The specific sequence of carboxyl terminal peptide 尾 (尾 -CTxX) of collagen type 鈪，

本文編號：1716273