【摘要】：目的觀察圍絕經(jīng)期2型糖尿病骨質(zhì)疏松癥治療中胰島素與阿侖膦酸鈉的聯(lián)合應(yīng)用效果。方法 168例圍絕經(jīng)期2型糖尿病骨質(zhì)疏松癥患者,隨機(jī)分為胰島素+阿侖膦酸鈉組、胰島素組、阿侖膦酸鈉組、對照組,每組42例。各組均口服骨化三醇膠丸0.25μg+碳酸鈣D3 600 mg+二甲雙胍1 500 mg/d口服,1次/d。胰島素+阿侖膦酸鈉組,胰島素0.5 IU/(kg.d)皮下注射,2次/d,口服阿侖膦酸鈉70 mg,1次/周;胰島素組使用胰島素早晚餐前皮下注射,劑量為0.5 IU/(kg.d);阿侖膦酸鈉組口服阿侖膦酸鈉70 mg,1次/周。共治療12個月。治療前、后采用測定各組腰椎和全髖骨密度(BMD)。治療前、后抽取各組空腹靜脈血5 mL,采用自動生化分析儀檢測空腹血糖,采用美國RAD公司試劑盒檢測糖化血紅蛋白(HbA_(1c)),采用ELISA法檢測血清骨保護(hù)素(OPG),采用酶聯(lián)免疫法檢測Ⅰ型膠原C端肽(CTX)。結(jié)果與治療前比較,治療后胰島素+阿侖膦酸鈉組腰椎、全髖BMD增加(P均0.05);與胰島素組、阿侖膦酸鈉組、對照組治療后比較,胰島素+阿侖膦酸鈉組腰椎、全髖BMD增加(P均0.05)。與治療前比較,治療后各組空腹血糖、HbA_(1c)均降低(P均0.05)。與治療前比較,治療后胰島素+阿侖膦酸鈉組血清OPG水平升高、CTX水平降低(P均0.05);與胰島素組、阿侖膦酸鈉組、對照組治療后比較,胰島素+阿侖膦酸鈉組OPG水平升高、CTX水平降低(P均0.05)。結(jié)論圍絕經(jīng)期2型糖尿病骨質(zhì)疏松癥治療中胰島素與阿侖膦酸鈉的聯(lián)合應(yīng)用效果較好。
[Abstract]:Objective to observe the effect of insulin combined with alendronate in the treatment of type 2 diabetic osteoporosis. Methods 168 cases of peri-menopausal type 2 diabetic osteoporosis were randomly divided into insulin alendronate group, insulin group, alendronate group and control group (42 cases in each group). Each group was treated with 0.25 渭 g calcium carbonate D3 600 mg metformin 1 500 mg/d orally, once a day. In insulin alendronate group, insulin 0.5 IU/ (kg.d) was injected subcutaneously twice a day, and alendronate was given orally for 70 mg,1 / week. The insulin group was subcutaneously injected with insulin in the morning and evening preprandial period (kg.d), and alendronate sodium was administered orally in the alendronate group for 70 mg,1 / week. The treatment lasted 12 months. Before and after treatment, the bone density of lumbar vertebrae and total hip were measured by (BMD). In each group. Before and after treatment, fasting venous blood was extracted for 5 mL, and fasting blood glucose was detected by automatic biochemical analyzer. HbA_ (1c), ELISA method) was used to detect serum osteoprotegerin (OPG), and HbA_ (1c),) was used to detect glycosylated hemoglobin (HbA_). Detection of type I collagen C-terminal peptide (CTX). By enzyme-linked immunosorbent assay Results compared with before treatment, the total hip BMD increased in the insulin alendronate group after treatment (P 0.05). Compared with insulin group, alendronate group and control group, BMD of lumbar vertebrae and total hip in insulin alendronate group increased after treatment (all P 0. 05). Compared with before treatment, fasting blood glucose and HbA_ (1c) in each group were decreased after treatment (P < 0. 05). Compared with before treatment, serum OPG level increased and CTX level decreased in insulin alendronate group after treatment (all P 0. 05). Compared with insulin group, alendronate group and control group, OPG level increased and CTX level decreased in insulin alendronate group. Conclusion the combination of insulin and alendronate is effective in the treatment of type 2 diabetic osteoporosis.
【作者單位】： 深圳市第二人民醫(yī)院;
【基金】：深圳市科技研發(fā)資金項目資助項目(JCYJ20150330102720148) 深圳市衛(wèi)生計生系統(tǒng)科研項目(201506021)
【分類號】：R580;R587.1

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