李晓峰;徐大霞;王闯;孔猛;陈允震;

• 1:山东大学齐鲁医院骨科

摘要(Abstract)：

[目的]分析骨代谢生化标志物在骨质疏松症治疗中对药物应用的指导意义,为骨质疏松药物治疗探索一条精准有效地治疗途径。[方法]采用自身前后对照临床研究,56例患者根据Ⅰ型前胶原N-端前肽(P1NP)与β-胶原特殊序列(β-cross Laps)测量值分为低骨转换组(30例)与高骨转换组(26例)。每组随机分别给予2种治疗方案:特立帕肽(20μg/d)与唑来膦酸注射液(5 mg/年),治疗时间为26个周,期间定期观察β-cross Laps、P1NP、腰椎、股骨颈骨密度(BMD)以及VAS疼痛评分的变化情况。[结果]在高、低骨转换组中,特立帕肽治疗后P1NP与β-cross Laps均较治疗前浓度升高(P<0.05),唑来膦酸治疗后P1NP与β-cross Laps均较治疗前浓度降低(P<0.05);低骨转换组特立帕肽治疗后腰椎BMD升高较唑来膦酸显著(P<0.05),高骨转换组唑来膦酸治疗后股骨颈BMD升高较特立帕肽显著(P<0.05);低骨转换组特立帕肽治疗后骨痛缓解优于唑来膦酸(P<0.05),高转换组中两种药物均能缓解骨痛,差异无统计学意义(P>0.05)。[结论]在原发性骨质疏松症治疗中,应以骨生化标志物作为药物选择的依据:低骨转换状态下以促成骨药物为主,高骨转换状态下以抑制骨吸收药物为主。

关键词(KeyWords)： 骨代谢;骨代谢生化标志物;骨密度;骨痛;原发性骨质疏松症

Abstract:

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基金项目(Foundation):

作者(Author): 李晓峰;徐大霞;王闯;孔猛;陈允震;

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参考文献(References)：

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