唑来膦酸、伊班膦酸钠及阿伦膦酸钠防治绝经后骨质疏松症的疗效对比研究

摘要

Objective To compare the efficacy of zoledronic acid, ibandronate and alendronate in postmenopausal osteoporosis. Methods 180 postmenopausal women were randomly divided into zoledronic acid treatment group ( ZOL group), ibandronate treatment group (IBA group) and alendronate treatment group (ALN group). ZOL group received zoledronic acid treatment, IBA group received ibandronate sodium treatment, and ALN group received alendronate treatment. Bone mineral density (BMD) of the lumbar spine and hip, serum bone metabolic markers and VAS score changes were measured before and after treatment, and the adverse drug reaction and the incidence of fracture were observed during the study. Results Bone density of lumbar vertebrae (L1-4) and left femoral neck increased significantly after 12 months of treatment, which was significantly higher than that of before treatment (P＜0. 05), but there were no significant differences among the three groups (P ＞ 0. 05). There was no significant difference in the effective rate of the three groups (P＞0. 05). The VAS score of the three groups was significantly lower than that of before treatment (P＜0. 05), but there were no significant differences among the three groups (P＞0. 05). The levels of serum type Ⅰ collagen cross-linked carboxy-terminal peptides ( CTX-I) and tartrate-resistant acid phosphatase-5b ( TRACP-5b ) were significantly lower in the three groups after 12 months of intervention, which were significantly lower than those before treatment (P＜0. 05), with no significant difference among the three groups (P＞0. 05). There were no significant differences in the incidence of adverse drug reactions between the three groups ( P＞0. 05). Conclusion Zoledronic acid, ibandronate and alendronate are safe and effective in postmenopausal osteoporosis, and can significantly improve bone mineral density and abnormal bone metabolism.%目的 对比研究唑来膦酸、伊班膦酸钠及阿伦膦酸钠对绝经后骨质疏松症的疗效.方法 180名绝经后妇女随机分为唑来膦酸治疗组(ZOL组)、伊班膦酸钠治疗组(IBA组)和阿伦膦酸钠治疗组( ALN组);ZOL组给予唑来膦酸治疗,IBA组给予伊班膦酸钠治疗,ALN组予以阿伦膦酸钠治疗.治疗前后分别检测3组受试者腰椎及髋部骨密度、血清骨代谢指标、视觉模拟评分(visual analogue scale,VAS)改变及研究期间药物不良反应和骨折发生率.结果 药物治疗12 个月后3 组腰椎(L1～4)及左侧股骨颈骨密度明显增加,显著高于治疗前(P＜0. 05),而3组间比较差异无统计学意义(P＞0. 05),3组治疗有效率比较差异无统计学意义(P＞0. 05).药物治疗12个月后3组患者的VAS评分均显著降低,显著低于治疗前(P＜0. 05),而3组间比较差异无统计学意义(P＞0. 05).干预12个月后两组血清 Ⅰ 型胶原交联羧基末端肽和抗酒石酸酸性磷酸酶-5b水平均显著降低,显著低于治疗前(P＜0. 05),而3组间比较差异无统计学意义(P＞0. 05). 3组间药物不良反应发生率比较差异无统计学意义(P＞0. 05).结论 唑来膦酸、伊班膦酸钠及阿伦膦酸钠对绝经后骨质疏松症的治疗安全有效,可以显著改善骨密度及骨代谢异常.