摘要
目的观察阿仑膦酸钠对类风湿关节炎（RA）合并骨质疏松或骨量减少的患者骨密度（BMD）的影响。方法将42例RA患者随机分成2组,所有患者均服用MTX10mg/周、叶酸片5mg/d和钙尔奇-D600mg/d,治疗组加用阿仑膦酸钠70mg/周,2组共服药6个月。使用双能X线吸收仪分别检测治疗前和治疗6个月后腰椎（L1~4）后前位、股骨颈、大转子、Ward区部位的BMD,评估RA疾病活动度并分析二者间的相关性。结果治疗6个月后治疗组RA患者的腰椎BMD与基线相比明显上升（P〈0.05）,并且高于对照组（P〈0.05）。而股骨颈、Ward区和大转子部位的BMD有所增加,但与基线及对照组相比,差异无统计学意义。21例治疗组患者经过6个月治疗后腰椎BMD的变化与RA疾病活动性指标如ESR、CRP、RF、HAQ评分、关节肿胀个数、关节压痛个数和DAS28均无相关性（P〉0.05）。结论与MTX联用,阿仑膦酸钠可增加骨质疏松或骨量减少RA患者的腰椎BMD,是治疗RA伴发骨质疏松或骨量减少的有效手段。
Objective To investigate the effects of alendronate on BMD in RA patients with osteoporosis or osteopenia Methods Forty two RA patients with standard treatment of Methotrexate 10 mg/w,Folic acid 5 mg/d,and vitamin D_3 600 mg/d,were randomly divided into two grous Compare to the control arm,the experimental arm added alendronate to standard treatment for 6 months BMD of the spine（L_1~4）,femoral neck,trochanter,and Ward＇s triangle region,as well as RA disease activity index,were evaluated and analyzed for correlation in both groups prior to the randomization and after completion of six month treatment Results Spine BMD in the experimental group after six month treatment was significantly improved compared with the baseline measurement（P0.05）,which was also superior to the control group（P0.05） BMD of the femoral neck,trochanter,and Ward＇s triangle region were elevated without statistical significance compared to the baseline and control group However,the improvement of BMD after six month alendronate treatment in the experimental group had no correlation with RA disease activity index including ESR,CRP,RF,HAQ scale,number of swollen joints,number of painful/tender joints,and DAS28 score Conclusion Adding alendronate to conventional anti rheumatic drugs can improve the spine BMD in RA patients with osteoporosis or osteopenia,and may have critical clinical implications in the treatment strategy of RA.
出处
《中国实用医药》
2011年第14期9-11,共3页
China Practical Medicine
关键词
阿仑膦酸钠
类风湿关节炎
骨质疏松
骨密度
Alendronate
Rheumatoid arthritis
Osteoporosis
Bone mineral density
