【摘要】 目的探讨阿仑膦酸钠及替勃龙对更年期妇女骨质疏松症患者MMP-2、9及骨转换的影响。方法选择2009年7月～2010年12月在笔者医院更年期门诊经BDM测量诊断为骨量减少或骨质疏松的围绝经期及绝经后年龄在46～75岁之间的86例女性,随机分为实验组46例,口服阿仑膦酸钠片70mg每周1次+替勃龙1.25mg/d+服用复方氨基酸鳌合钙口服1000mg/d;对照组40例,口服氨基酸螯合钙1000mg/d。两组妇女均连续服药48周。治疗前、后采用酶联免疫法检测血清基质金属蛋白酶-2(MMP-2)和基质金属蛋白酶-9(MMP-9)、骨碱性磷酸酶(BALP)、1型胶原C端肽(CTX)、25羟维生素D3[25(OH)D3]。结果 86例中共9例(10.47%)未完成研究,具体原因如下:试验组退出5例(上腹部隐痛不适,烧灼感3例,恐癌2例)。对照组4例(失访1例,自动退出3例),退出病例未纳入统计,退出病例未纳入统计。①骨代谢指标:BALP及CTX两组治疗后均较治疗前显著下降,差异有统计学意义(P<0.05);25(OH)D3治疗后实验组较治疗前显著上升,对照组较治疗前显著下降,差异有统计学意义(P<0.05);②MMP:MMP-2及MMP-9治疗后实验组较治疗前显著下降,对照组较治疗前显著上升,差异有统计学意义(P<0.05)。结论阿仑膦酸钠及替勃龙可用于OP的治疗,可降低MMP-2、9及骨转换,对治疗骨质疏松症有理论依据和临床意义。更多还原

【Abstract】 Objective To observe the influences of alendronate and tibolone combination treatment in osteoporosis menopause women on the levels of matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9) and bone turnover markers.Methods Eighty-six perimenopause or postmenopause women who were diagnosed as osteopenia or osteoporosis by BDM test from July 2009 to December 2010 were studied and divided into 2 groups randomly.Forty-six women,as the experimental group,oraly took the bisphosphonates 70mg/w + Tibolone 1.25mg+Osteoform 1000mg/d for 48 weeks,while in the control group,only Osteoform 1000mg/d was taken.MMP-2,9 as well as biochemical bone turnover markers such as bone alkaline phosphatase(BALP),cross linked clelopeptide of type I collagen(CTX) and 25-hydroxychole calciferol [25(OH)D3] were measured before and after the treatment.Results The level of BALP and CTX decreased significantly after the treatment in both groups(P<0.05).The level of 25(OH)D3 in the test group was significantly higher after the treatment,while in the control,it had a significant decrease(P<0.05).Compared to the level of MMP-2 and MMP-9 before the treatment,those in the test group decreased significantly,and increased in the control,(P<0.05)Conclusion Combined use of alendronate and tibolone can lower the level of MMP-2,MMP-9,and bone turnover markers.And base on this theory,it may be a clinical useful therapy for osteoporosis.Both of them can decrease the level of MMP-2、9 and bone turnover marker and are good for the theory and experiment of osteoporosis.更多还原