【摘要】 目的:探讨特立帕肽对老年髋部骨折患者骨密度（BMD）,血清β-Ⅰ型胶原交联羧基末端肽（β-CTX）、1型前胶原氨基末端前肽（P1NP）和骨钙素（OCN）的影响。方法:采用随机对照研究,选取2017—2018年北京积水潭医院收治的老年髋部骨折患者70例,以随机数字表法分为特立帕肽组和对照组,每组35例。术后第1日给予药物干预,对照组患者应用抗骨质疏松基础用药治疗,特立帕肽组患者在对照组的基础上联合应用特立帕肽。观察两组患者治疗前,治疗14、28 d的血清β-CTX、P1NP和OCN水平变化情况,以及治疗前和治疗后6个月的BMD水平变化情况。结果:治疗6个月后,使用定量CT测量两组患者腰椎（L₁—L₄）BMD,结果显示,特立帕肽组患者腰椎（L₁—L₄） BMD明显高于治疗前和对照组治疗后,差异有统计学意义（P <0.05）。治疗14、28 d后,特立帕肽组患者血清β-CTX水平稍低于本组治疗前和对照组,但差异均无统计学意义（P> 0.05）。治疗14、28 d后,特立帕肽组患者血清P1NP和OCN水平较治疗前显著升高,且明显高于对照组,差异均有统计学意义（P <0.05）。结论:老年髋部骨折患者骨折早期应用特立帕肽联合抗骨质疏松基础用药治疗,能显著提高血清P1NP、OCN水平,并能提高BMD水平。更多还原

【Abstract】 OBJECTIVE: To probe into the effect of teriparatide on bone mineral density（ BMD） and serum beta C-terminal telopeptide of type Ⅰ collagen（ β-CTX）, type 1 procollagen amino terminal propeptide（ P1 NP）,osteocalcin（ OCN） in elderly patients with hip fracture. METHODS: A randomized controlled trial was performed,totally 70 elderly patients with hip fracture admitted into Beijing Jishuitan Hospital during 2017-2018 were selected and divided into teriparatide group and control group via random number table,with 35 cases in each group. Interventions were conducted on the first postoperative day,the control group was treated with anti-osteoporosis drugs,while the teriparatide group was given teriparatide based on the control group. Changes of serum β-CTX,P1 NP and OCN levels of before treatment,after 14 d and 28 d of treatment,changes of BMD levels of before treatment and 6 months after treatment were observed. RESULTS: After 6-month treatment,the BMD of lumbar spine（ L₁-L₄） of patients in both groups were measured by quantitative CT,the results showed that the BMD of lumbar spine（ L₁-L₄） of teriparatide group was significantly higher than that of before treatment and after treatment in the control group,with statistically significant difference（ P < 0. 05）. After 14 d and 28 d of treatment,the serum β-CTX level of teriparatide group was slightly lower than that of before treatment and the control groups,but the differences were not statistically significant（ P > 0. 05）. After 14 d and 28 d of treatment,the serum P1 NP and OCN levels of teriparatide group were significantly higher than those of before treatment and the control group,with statistically significant differences（ P < 0. 05）.CONCLUSIONS: Early application of teriparatide combined with anti-osteoporosis drugs in elderly patients with hip fracture can significantly increase serum P1 NP and OCN levels,and improve patients’ BMD.更多还原