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目的:探讨脑卒中后偏瘫患者预防性使用抗骨质疏松药物对其手功能的影响。方法:选取衢州市第三医院2018年1月至2019年10月收治的脑卒中后偏瘫患者66例为研究对象，采用随机数字表法分为观察组、对照组各33例。对照组给予常规康复治疗，观察组在常规康复治疗基础上给予碳酸钙D3联合骨化三醇预防性抗骨质疏松治疗，两组患者连续治疗12周。比较两组治疗前后Brunnstrom分期评分、上肢Fugl-Meyer(FMA)评分、Wolf运动评分、改良Barthel指数评分、骨密度(BMD)、骨标志物变化。结果:治疗4周、8周、12周，观察组Brunnstrom分期评分分别为(2.97±0.90)分、(3.89±1.04)分、(4.68±1.04)分，均高于对照组的(2.46±0.89)分、(3.13±0.97)分、(4.09±0.97)分(n t＝2.315、3.070、2.383，均n P<0.05)；FMA评分分别为(34.28±5.17)分、(49.12±6.24)分、(55.73±6.74)分，均高于对照组的(30.07±5.05)分、(44.78±6.03)分、(50.10±6.71)分(n t＝3.346、2.873、3.401，均n P<0.05)；Wolf运动评分分别为(1.83±0.45)分、(2.91±0.64)分、(3.96±0.91)分，均高于对照组的(1.49±0.49)分、(2.28±0.57)分、(3.42±0.83)分(n t＝2.936、4.223、2.519，均n P<0.05)；Barthel指数评分分别为(59.12±5.73)分、(71.34±6.03)分、(78.98±6.89)分，均高于对照组的(55.14±5.62)分、(65.23±6.19)分、(71.54±6.80)分(n t＝2.849、4.062、4.415，均n P<0.05)。治疗4周、8周、12周，观察组腰椎、髋部BMD水平均高于对照组，差异均有统计学意义(均n P<0.05)。治疗4周、8周、12周，观察组总I型胶原氨基端前肽分别为(76.02±7.26)μg/L、(58.34±6.45)μg/L、(49.12±5.12)μg/L，均低于对照组的(79.98±7.13)μg/L、(64.48±6.71)μg/L、(54.29±5.15)μg/L(n t＝2.236、3.790、4.090，均n P<0.05)；血清骨钙素分别为(3.41±0.53)ng/L、(4.75±0.49)ng/L、(6.09±0.72)ng/L，均高于对照组的(3.02±0.48)ng/L、(4.16±0.47)ng/L、(5.41±0.67)ng/L(n t＝3.133、4.992、3.972，均n P<0.05)；25-二羟维生素D3分别为(34.87±5.41)ng/L、(48.71±5.67)ng/L、(72.67±6.95)ng/L，均高于对照组的(30.22±5.30)ng/L、(42.35±5.12)ng/L、(64.62±6.14)ng/L(n t＝3.527、4.782、4.987，均n P<0.05)。n 结论:对脑卒中后偏瘫患者预防性使用抗骨质疏松药物干预有显著的效果，可改善患者的手部及上肢功能，改善患者的生活质量，提高患者的骨密度及改善患者骨代谢指标。“,”Objective:To explore the effect of prophylactic use of anti-osteoporosis drugs on hand function in hemiplegic patients after stroke.Methods:From January 2018 to October 2019, 66 patients with hemiplegia after stroke admitted to the Third Hospital of Quzhou were selected and randomly divided into observation group and control group according to the random digital table method, with 33 cases in each group.The control group was given routine rehabilitation treatment, the observation group was given calcium carbonate D3 combined with calcitriol preventive anti-osteoporosis treatment.The two groups were treated for 12 weeks.Before and after treatment, the Brunnstrom stage score, Fugl Meyer(FMA) score, Wolf exercise score, modified Barthel index score, bone mineral density(BMD) and bone markers were compared between the two groups.Results:After treatment for 4, 8, 12 weeks, the Brunnstrom stage scores of the observation group were (2.97±0.90)points, (3.89±1.04)points, (4.68±1.04)points, respectively, which were higher than those of the control group[(2.46±0.89)points, (3.13±0.97)points, (4.09±0.97)points](n t=2.315, 3.070, 2.383, all n P<0.05)and the FMA scores of the observation group were (34.28±5.17)points, (49.12±6.24)points, (55.73±6.74)points, respectively, which were higher than those of the control group [(30.07±5.05)points, (44.78±6.03)points, (50.10±6.71)points] (n t=3.346, 2.873, 3.401, all n P<0.05), and the Wolf exercise scores of the observation groupwere (1.83±0.45)points, (2.91±0.64)points, (3.96±0.91)points, which were higher than those of the control group [(1.49±0.49)points, (2.28±0.57)points, (3.42±0.83)points] (n t=2.936, 4.223, 2.519, all n P<0.05), and the Barthel index scores of the observation group were (59.12±5.73)points, (71.34±6.03)points, (78.98±6.89)points, respectively, which were higher than those of the control group [(55.14±5.62)points, (65.23±6.19)points, (71.54±6.80)points] (n t=2.849, 4.062, 4.415, all n P<0.05). After 4, 8 and 12 weeks of treatment, BMD level of lumbar spine and hip in the observation group were higher than those in the control group, and the differences were statistically significant(alln P<0.05). After 4, 8 and 12 weeks of treatment, the total amino terminal propeptides of type I collagen in the observation group were (76.02±7.26)μg/L, (58.34±6.45)μg/L, (49.12±5.12)μg/L, respectively, which were lower than those in the control group[(79.98±7.13)μg/L, (64.48±6.71)μg/L, (54.29±5.15)μg/L](n t=2.236, 3.790, 4.090, all n P<0.05), and the serum osteocalcin levels in the observation group were (3.41±0.53)ng/L, (4.75±0.49)ng/L, (6.09±0.72)ng/L, respectively, which were higher than those of the control group [(3.02±0.48)ng/L, (4.16±0.47)ng/L, (5.41±0.67)ng/L](n t=3.133, 4.992, 3.972, all n P<0.05)and the 25 dihydroxyvitamin D3 levels in the observation group were (34.87±5.41)ng/L, (48.71±5.67)ng/L, (72.67±6.95)ng/L, respectively, which were higher than those of the control group [(30.22±5.30)ng/L, (42.35±5.12)ng/L, (64.62± 6.14)ng/L](n t=3.527, 4.782, 4.987, all n P<0.05).n Conclusion:The preventive use of anti-osteoporosis drugs in patients with hemiplegia after stroke has significant effect, which can improve the function of hands and upper limbs, improve the quality of life of patients, improve the bone density and improve the bone metabolism index of patients.