中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (46): 6893-6898.doi: 10.3969/j.issn.2095-4344.2016.46.007

• 骨组织构建 bone tissue construction • 上一篇    下一篇

阿仑膦酸钠与激素替代疗法治疗骨质疏松症的比较

苏  凡1，林静霞2，吴利秋3，蔡冬梅1，庄  泽4   

  1. 中山大学附属第一医院，1骨质疏松科，2输血科，3预防保健科，广东省广州市  510080；4中山大学附属第三医院关节创伤外科，广东省广州市  510630
  • 收稿日期:2016-08-26 出版日期:2016-11-11 发布日期:2016-11-11
  • 通讯作者: 庄泽，硕士，主治医师，中山大学附属第三医院关节创伤外科，广东省广州市 510630
  • 作者简介:苏凡，女，1983年生，广东省普宁市人，汉族，2002年中山大学临床医学院毕业，医师，主要从事骨质疏松研究。

Effects of alendronate sodium versus hormone replacement therapy for osteoporosis

Su Fan1, Lin Jing-xia2, Wu Li-qiu3, Cai Dong-mei1, Zhuang Ze4   

  1. 1Department of Osteoporosis, 2Department of Blood Transfusion, 3Department of Prevention and Health, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China; 4Department of Joint and Traumatology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
  • Received:2016-08-26 Online:2016-11-11 Published:2016-11-11
  • Contact: Zhuang Ze, Master, Attending physician, Department of Joint and Traumatology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
  • About author:Su Fan, Physician, Department of Osteoporosis, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China

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被引次数

17

摘要：

文章快速阅读：

文题释义：
激素替代疗法(hormone replacement therapy，HRT)：是指通过补充激素来治疗激素分泌减退或者缺乏所引起的疾病的治疗方法。广义上的HRT涵盖所有的激素。狭义上的HRT多是针对女性激素，特别是指雌激素替代疗法(estrogen replacement therapy，ERT)。美国公布的研究结果显示，虽然激素替代疗法能帮助中老年妇女改善更年期不适症状，但这种疗法也会增加女性患痴呆症的风险。新结果再次表明需要对激素替代疗法的利弊进行重新评估。
骨质疏松症：是由于多种原因导致的骨密度和骨质量下降，骨微结构破坏，造成骨脆性增加，从而容易发生骨折的全身性骨病。绝经后骨质疏松症一般发生在妇女绝经后5-10年内。

摘要
背景：研究表明雌激素、双膦酸盐、降钙素等可在一定程度上提高骨密度和降低骨折发生率，其中阿仑膦酸钠作为临床最常用的双膦酸盐类药物得到人们的关注。
目的：对比分析阿仑膦酸钠与激素替代疗法治疗绝经后骨质疏松症的疗效。
方法：绝经后骨质疏松症患者198例随机平均分为2组，每组99例，阿仑膦酸钠组口服阿仑膦酸钠，每周70 mg，连续1年；激素代替疗法组口服替勃龙片2.5 mg/d，连续1年，比较治疗前后2组的骨密度、性激素水平，并比较2组患者的不良发应发病率及对骨代谢标志物的影响，同时进行疼痛改善评价。
结果与结论：①治疗之后2组的股骨颈及L1-4的骨密度均较治疗前有所改善(P < 0.05)；②激素代替疗法组治疗后血清雌激素和孕酮浓度均有下降的趋势，皮质醇有升高的趋势(P < 0.05)；③目测类比评分阿仑膦酸钠组优于激素代替疗法组(P < 0.05)；④阿仑膦酸盐组血清Ⅰ型原骨胶原 N端肽、血清β胶原降解产物治疗后较激素代替疗法组下降明显(P < 0.05)、阿仑膦酸钠组血清骨源性碱性磷酸酶和血清骨钙素较激素代替疗法组上升(P < 0.05)；⑤激素替代疗法组的恶心、乏力等不良发应发病率高于阿仑膦酸钠组(P < 0.05)；⑥结果说明，阿仑膦酸钠与激素替代疗法治疗绝经后骨质疏松症均可有效的提高骨密度，促进骨形成，阿仑膦酸钠对患者激素水平影响较小且不良反应小，其治疗效果更佳。

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程
ORCID: 0000-0003-1435-913X(苏凡)

关键词: 组织构建, 骨组织工程, 阿仑膦酸钠, 激素替代疗法, 绝经后, 骨质疏松症, 骨密度, 骨代谢标志物

Abstract:

BACKGROUND: Estrogen, bisphosphonates, and calcitonin have been shown to improve bone density and decrease fracture rate, among which, alendronate sodium is the most commonly used and gains extensive attention.
OBJECTIVE: To compare the treatment outcomes of alendronate sodium and hormone replacement therapies for postmenopausal osteoporosis. 
METHODS: 198 cases of postmenopausal osteoporosis were randomly divided into two groups (n=99 per group), and then respectively given the oral administration of alendronate sodium, 70 mg weekly, continuous for 1 year, and the oral treatment of tibolone tablets (hormone replacement therapy group),
2.5 mg/d, for 1 consecutive year. The bone density and sex hormone levels before and after treatment, the incidence of adverse reactions and the levels of bone turnover makers were compared between two groups. Furthermore, visual analogue scale scores were detected.
RESULTS AND CONSLUSION: The bone densities of the femoral neck and L1-4 were significantly improved in both groups after treatment (P < 0.05). The hormone replacement therapy significantly decreased the serum levels of estradiol and progesterone, and significantly increased the cortisol level  (P < 0.05). The visual analogue scale scores in the alendronate sodium group were significantly superior to those in the hormone replacement therapy group (P < 0.05). Alendronate sodium significantly decreased serum levels of procollagen type I N-terminal peptide and C-terminal cross-linking telopeptide of type I collagen, as well as significantly increased alkaline phosphatase and osteocalcin compared with the hormone replacement therapy (P < 0.05). The incidence of adverse reactions, such as nausea and fatigue, in the hormone replacement therapy group was higher than that in the alendronate sodium group (P < 0.05). These results suggest that alendronate sodium and hormone replacement therapies both can markedly improve the bone density and promote osteogenesis; in contrast, alendronate sodium exerts little influence on hormone levels and slight adverse reactions, achieving better treatment outcomes.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Hormone Replacement Therapy, Postmenopause, Osteoporosis, Bone Density, Tissue Engineering

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