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目的通过观察阿仑膦酸钠治疗绝经后骨质疏松或骨量减少1年后骨密度和骨吸收指标(β-CTX)的变化,了解骨密度变化与骨吸收指标变化的关系。方法入选了35例绝经后骨质疏松或骨量减少患者,给予阿仑膦酸钠70mg/w,碳酸钙600 mg/d和维生素D125 IU/d,治疗12 m。在基线和治疗12 m后进行DXA骨密度测定,在基线、治疗3 m和12 m后测定骨吸收指标β-CTX。结果治疗1年后腰椎2~4、股骨颈和全髋骨密度均有上升,而所有受试者治疗3m后β-CTX均较基线下降(74.21±43.66)%。治疗3m后β-CTX的变化率和治疗12m后腰椎2~4和股骨颈骨密度绝对值呈相关(Betastd=-0.418,P=0.017;Betastd=-0.321,P=0.032)。结论治疗3 m骨吸收指标β-CTX的变化率有望成为预示患者对阿仑膦酸钠反应的早期指标。
Objective To investigate the relationship between changes of bone mineral density (BMD) and changes of bone resorption by observing the changes of bone mineral density and bone resorption index (β-CTX) after alendronate treatment of postmenopausal osteoporosis or bone mass reduction one year later. Methods 35 patients with postmenopausal osteoporosis or osteopenia were enrolled and were given alendronate sodium 70mg / w, calcium carbonate 600 mg / d and vitamin D125 IU / d for 12 m. DXA BMD was measured at baseline and 12 m after treatment, and bone resorption index β-CTX was measured at baseline and after 3 m and 12 m of treatment. Results After 1 year of treatment, the lumbar spine 2 ~ 4, femoral neck and total hip BMD increased. However, the β-CTX of all the subjects decreased by 74.21 ± 43.66% after 3 months of treatment. The change rate of β-CTX after 3m of treatment was correlated with the absolute value of lumbar spine 2-4 and femoral neck BMD after 12m of treatment (Betastd = -0.418, P = 0.017; Betastd = -0.321, P = 0.032). Conclusion The rate of change of β-CTX, a measure of 3-m bone resorption, is expected to be an early predictor of response to alendronate.