2020 年第 1 期 第 15 卷

老年女性骨质疏松症患者静脉滴注唑来膦酸后24个月内骨转换标志物的变化

Changes of bone turnover markers in elderly osteoporosis women during 24 months after intravenous infusion of zoledronic acid

作者：沈坚英1朱红娅1寿张轩2边平达1

英文作者：

单位：1浙江省人民医院杭州医学院附属人民医院望江山院区老年医学科310024；2浙江省人民医院杭州医学院附属人民医院望江山院区药学部310024

英文单位：

关键词：骨质疏松症；唑来膦酸；骨转换标志物

英文关键词：

• 摘要：

• 【摘要】目的    探讨老年女性骨质疏松症（OP）患者静脉滴注唑来膦酸后24个月内骨转换标志物的变化规律。方法    选择浙江省人民医院/杭州医学院附属人民医院望江山院区2015年1月至2016年 12月收治的老年女性OP患者37例（年龄70~89岁），均给予唑来膦酸5 mg静脉滴注，此后服用碳酸钙D3片和阿法骨化醇软胶囊治疗，持续24个月。定期检测患者血清Ⅰ型胶原羧基末端肽交联、1型前胶原氨基端前肽和骨钙素水平。结果    37例老年女性OP患者在接受唑来膦酸治疗后24个月内，血清Ⅰ型胶原羧基末端肽交联、1型前胶原氨基端前肽和骨钙素水平均出现先下降后缓慢升高的变化，且到治疗后24个月时仍明显低于治疗前［（0.26±0.12）μg/L比（0.47±0.20）μg/L、（38±21）μg/L比（52±21）μg/L、（14.0±5.4）μg/L比（20.4±6.2）μg/L］（均P＜0.05）。结论    老年女性OP患者接受单次唑来膦酸治疗24个月后，其常见血清骨转换标志物指标仍处于较低水平，可考虑适当延长唑来膦酸的使用间隔。

• 【Abstract】Objective    To analyze the changes of bone turnover markers during 24 months following a single dose of zoledronic acid infusion in elderly osteoporosis women. Methods    A total of 37 elderly osteoporosis women（70-89 years old） were enrolled from January 2015 to December 2016 in Wangjiangshan Branch of Zhejiang Provincial People′s Hospital ＆ People′s Hospital of Hangzhou Medical College. All patients were given a single dose(5 mg) of zoledronic acid infusion, and took calcium carbonate D3 tablets and alfacalcidol soft capsules for 24 months. Serum levels of C-terminal telopeptide of type Ⅰ collagen(CTX), procollagen type Ⅰ N-terminal propeptide(P1NP) and osteocalcin(OC) were detected regularly after medication. Results    A pattern of slight increase following significant decrease was observed in serum levels of CTX, P1NP and OC. The levels of CTX, P1NP and OC at 24 months after using zoledronic acid were still significantly lower than those before medication［（0.26±0.12）μg/L vs （0.47±0.20）μg/L, （38±21）μg/L vs （52±21）μg/L, （14.0±5.4）μg/L vs （20.4±6.2）μg/L］(all P＜0.05). Conclusion    A prolonged dosing interval of zoledronic acid treatment may be advisable for elderly osteoporosis women on the basis of decreased serum levels of common bone turnover markers at 24 months after a single dose infusion.