| 罗建,聂桂峰,黄小虎,等.固力康联合钙尔奇D在骨质疏松症合并股骨粗隆间骨折治疗中的疗效及其对骨代谢指标的影响[J].安徽医药,2017,21(6):1101-1105. |
| 固力康联合钙尔奇D在骨质疏松症合并股骨粗隆间骨折治疗中的疗效及其对骨代谢指标的影响 |
| The effect of menatetrenone soft capsules with Caltrate Din the treatment of osteoporosis and femoral intertrochanteric fracture and its effect on bone metabolism index |
| 投稿时间：2016-10-17 |
| DOI： |
| 中文关键词: 固力康 骨质疏松性骨折 骨痛 骨密度 骨代谢标志物 骨硬化蛋白 |
| 英文关键词: Menatetrenone soft capsules Osteoporotic fracture Bone pain Bone density Bone metabolism marker Sclerostin |
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| 中文摘要: |
| 目的 探讨固力康联合钙尔奇D在骨质疏松症合并股骨粗隆间骨折治疗中的临床疗效,及其对骨密度(BMD)、血清骨硬化蛋白(sclerostin)和骨代谢标志物影响。方法 将150例骨质疏松性股骨粗隆间骨折病人,采用随机双盲对照法分为两组,每组75例,两组病人均经股骨近端髓内钉内固定后,对照组病人给予钙尔奇D口服,治疗组采用固力康联合钙尔奇D,连续用药治疗1年。观察两组病人的临床疗效,测定骨密度,并检测血清中抗酒石酸酸性磷酸酶5b(TRAP5b)、β-胶原特殊序列(β-CTX)、总Ⅰ型前胶原氨基端前肽(T-PINP)、N 端中段骨钙素(N-MID)和sclerostin水平。结果 在治疗3个月后治疗组血清TRAP5b、β-CTX、sclerostin水平降低[(2.47±0.42) U·L-1、(188.46±72.35) ng·L-1、(10.16±3.55) ng·L-1],低于对照组[(3.23±0.25) U·L-1、(325.56±83.56) ng·L-1、(12.78±4.26) ng·L-1；t=13.466、10.742、4.092,均P<0.01],血清T-PINP、 N-MID水平升高[(28.57±8.76)、(22.78±7.56) μg·L-1],高于对照组[(23.75±7.46)、(17.66±8.65) μg·L-1；t=3.628、3.860,均P<0.01]。治疗1年后治疗组骨痛缓解情况优于对照组(t=19.709,P<0.01)。 此外,治疗1年后,治疗组与对照组腰椎、股骨颈、 Ward氏三角区骨密度均升高[(0.818±0.043)、(0.701±0.055)、(0.503±0.045) g·cm-2],优于对照组[(0.703±0.063)、(0.629±0.035)、(0.429±0.041) g·cm-2；t=13.060、9.565、10.527,均P<0.01],且腰椎BMD升高更加显著。结论 固力康联合钙尔奇D治疗骨质疏松性股骨粗隆间骨折病人有良好的效果,能促进骨形成,抑制骨吸收,减缓骨量丢失,提高骨密度,尤其增加腰椎BMD,可短时间内改善骨代谢指标,降低sclerostin水平,促进骨折愈合,并能够改善骨痛。 |
| 英文摘要: |
| Objective To explore the clinical curative effect and the influence of bone mineral density (BMD),serum sclerostin and bone metabolism markers in the treatment of osteoporosis complicated with femoral intertrochanteric with the Menatetrenone soft capsules and Caltrate D.Methods A total of 150 cases of osteoporotic femoral intertrochanteric fracture were randomly divided into two groups,each of 75 cases.Two patients were treated with proximal femoral intramedullary nail fixation,the control group were treated with Caltrate Dorally,treatment group were treated with Menatetrenone soft capsules combined with Caltrate D.The treatment lasted for one year.To observe the clinical efficacy of the 2 groups of patients,the bone mineral density,tartrate resistant acid phosphatase 5b (TRAP5b),a special sequence of beta collagen (β-CTX),total type Iprocollagen N-terminal propeptide (T-PINP),N terminus of osteocalcin (N-MID)and sclerostin level were measured.Results After 3 months of treatment the serum TRAP5b,P-CTX,the level of sclerostin in the treatment group were lower[(2.47±0.42) U·L-1,(188.46±72.35) ng·L-1,(10.16±3.55) ng·L-1] than in the control group [(3.23±0.25) U·L-1,(325.56±83.56) ng·L-1,(12.78±4.26) ng·L-1；t=13.466,10.742,4.092,P<0.01],the levels of the serum T- PINP and N-MID were higher [(28.57±8.76),(22.78±7.56) μg·L-1]than those in control group [(23.75±7.46),(17.66±8.65) μg·L-1；t=3.628,3.860,P< 0.01].After one year of treatment,in both the treatment group and control group,the bone mineral density of lumbar,femoral neck and Ward′s triangle was increased [(0.818±0.043)、(0.701±0.055)、(0.503±0.045) g·cm-2],that were superiorer to the control group [(0.703±0.063),(0.629±0.035),(0.429±0.041) g·cm-2；t=13.060,9.565,0.527,P<0.01)].The BMD of lumbar spine increased significantly.In addition,after one year of treatment,the pain relief in the treatment group was higher than that of control group (t=19.709,P<0.01).Conclusions Menatetrenone soft capsules combined with Caltrate Din the treatment of osteoporotic femoral intertrochanteric fracture patients which have a good effect can promote bone formation,inhibit bone resorption,decrease bone loss,improve bone density,especially increase the lumbar spine BMD,and can improve the bone metabolism index in a short period of time,reduce the level of sclerostin,promote fracture healing and improve bone fracture healing. |
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