鲑鱼降钙素联合钙尔奇D治疗糖尿病伴骨质疏松的疗效观察(1)
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【摘要】 目的 探讨鲑鱼降钙素联合钙尔奇D治疗糖尿病伴骨质疏松症患者的疗效及安全性。方法 16例糖尿病伴骨质疏松症患者用鲑鱼降钙素50 IU 1次/d,肌肉注射,同时服用钙尔奇D,600 mg/d,连续治疗4个周。在治疗前、治疗后分别测量骨密度(BMD)、骨代谢指标骨钙素(BGP),血钙、血磷、肝肾功能等,观察骨质疏松症腰背疼痛症状的治疗效果。结果 治疗4个周后骨密度较治疗前明显升高,骨钙素显著高于治疗前,甲状旁腺激素和碱性磷酸酶二者显著减低,腰背疼痛等骨病症状减轻甚至消失。结论 鲑鱼降钙素加钙尔奇D能够抑制骨吸收,促进骨形成,降低骨转换,并能迅速改善腰背疼痛症状,对糖尿病伴骨质疏松症治疗效果显著。
【关键词】糖尿病; 骨质疏松; 鲑鱼降钙素;钙尔奇D
The Efficacy of Salmon Calcitonin combined with Caltrate D in Treatment of Diabetes Mellitus complicated with Osteoporosis
DAI Ling.Eighth People’s Hospital of Zibo City,Shandong Province,Zibo 255000,China
【Abstract】 Objective To study the efficacy and safety of salmon calcitonin combined with caltrate D in treatment of diabetes mellitus complicated with osteoporosis.Methods 16 patients with diabetes mellitus complicated with osteoporosis were given salmon calcitonin,50IU,im,qd,and caltrate D 600 mg/d for 4 weeks.The
作者单位:255000山东省淄博市第八人民医院
bone mineral density(BMD),bone metabolic markers osteocalcin(BGP),serum calcium,phosphorus,liver and kidney function were measured before and after treatment to observe the treatment effect of osteoporosis with pain on low back.Results After 4 weeks of treatment the BMD and BGP were significantly higher,parathyroid hormone and alkaline phosphatase were significantly lower,the symptoms of bone disease like the low back pain reduced or disappeared.Conclusion Salmon calcitonin combined with caltrate D can inhibit bone resorption and promote bone formation,reduce bone change,and rapidly improve the symptoms of low back pain,and has significant effect in treatment of diabetes mellitus complicated with osteoporosis.
【Key words】Diabetes mellitus; Osteoporosis; Salmon calcitonin; Caltrate D
糖尿病伴骨质疏松是临床上很常见的现象,是由于糖尿病患者胰岛素绝对或相对缺乏导致机体糖、蛋白质、脂肪代谢紊乱,钙、磷、镁等微量元素代谢障碍引起骨组织量减少,甚至出现病理性骨折的代谢性骨病。其发病率各文献报道不一,国内外报道为9.8%~66%,可能与测定方法,选择对象及诊断标准不同有关。国外报道近半数糖尿病患者发生骨质疏松,以NIDDM居多[1],国内报差距更大14.6%~66%[2],主要与空腹血糖及血糖控制程度有关,而与年龄无关,经常处于高血糖状态的病情控制不良者易发生骨质疏松,事实上属于继发症,该疾病是近几年才开始被医学界认识。Levin[3]报道糖尿病患者中有50%合并骨质疏松,而骨质疏松一旦发生,不可逆转,所以重在预防。我院自2008至今用鲑鱼降钙素联合钙尔奇D治疗糖尿病伴骨质疏松症患者16例,取得了较好的效果,总结报告如下。
1 资料与方法
1.1 一般资料 所选糖尿病伴骨质疏松症患者16例,其中女10例,男6例,全部来自门诊就诊和病房住院患者,年龄51~78岁,病程一般为1~5年。经X线骨密度仪检测骨矿密度(BMD),并且均伴有不同程度骨痛、抽搐、腰背酸痛等临床症状,确诊为骨质疏松症,血钙、磷、碱性磷酸酶正常,同时排除甲旁亢,多发性骨髓瘤,长期应用糖皮质激素等所致继发性骨质疏松症,无严重食管、胃肠道、心、肝、肾病变,过去3个月未使用影响骨代谢药物,如活性维生素D、雌激素、钙制剂、二磷酸盐等,所有患者同意参与本研究 ......
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