不同剂量鲑鱼降钙素治疗老年骨质疏松症病人的临床疗效及安全性研究

doi:10.3969/j.issn.1003-9198.2025.04.008

摘要/Abstract

摘要： 目的探究不同剂量鲑鱼降钙素对老年骨质疏松症病人骨钙素(OST)、Ⅰ型前胶原氨基端前肽(PINP)及骨痛缓解程度的影响以及临床安全性。方法选取2021年8月至2023年7月就诊于新疆生产建设兵团医院的老年骨质疏松症病人106例作为研究对象,随机划分为低剂量鲑鱼降钙素组(n=53)和高剂量鲑鱼降钙素组(n=53),所有病人均接受阿仑膦酸钠作为基础治疗方案,低剂量鲑鱼降钙素组病人接受鲑鱼降钙素注射液肌肉注射启动治疗的前2周,50 IU/次,每2天1次,从第3周起,每周注射1次,50 IU/次;高剂量鲑鱼降钙素组启动治疗的前2周,50 IU/d,从第3周起,每周注射1次,100 IU/次,所有病人均连续治疗3个月。对比2组病人一般临床资料,治疗前后OST、PINP、血清Ⅰ型胶原羧基端肽β特殊序列(β-CTx)、骨密度(股骨颈、腰椎、髋部)的差异;通过VAS评估2组病人治疗前后骨痛程度的变化;对比2组病人临床疗效及不良反应发生率。结果治疗后2组血清OST、β-CTx水平均显著低于治疗前,PINP水平显著高于治疗前(P<0.05),且高剂量鲑鱼降钙素组血清OST、β-CTx水平均显著低于低剂量鲑鱼降钙素组, PINP水平显著高于低剂量鲑鱼降钙素组(P<0.05)。治疗后2组股骨颈、腰椎、髋部骨密度水平均显著高于治疗前(P<0.05),且高剂量鲑鱼降钙素组股骨颈、腰椎、髋部骨密度水平均显著高于低剂量鲑鱼降钙素组(P<0.05)。治疗后2组VAS评分显著低于治疗前(P<0.05),且高剂量鲑鱼降钙素组VAS评分显著低于低剂量鲑鱼降钙素组(P<0.05)。高剂量鲑鱼降钙素组病人总治疗有效率为94.34%、不良反应发生率为18.87%,与低剂量鲑鱼降钙素组(90.57%和11.32%)比较,差异均无统计学意义(P>0.05)。结论较高剂量的鲑鱼降钙素治疗老年骨质疏松症病人具有更好的临床效果,能更显著地改善病人骨代谢及骨密度水平。同时,较高剂量的鲑鱼降钙素可在保证临床安全性的同时降低病人骨痛程度,具有一定临床应用前景。

关键词: 老年人, 骨质疏松, 骨代谢, 鲑鱼降钙素, 骨痛

Abstract: Objective To investigate the impact of different doses of salmon calcitonin on the levels of osteocalcin(OST), N-terminal propeptide of type I procollagen(PINP) and bone pain, and the safety in the elderly patients with osteoporosis. Methods A total of 106 elderly patients with osteoporosis at Xinjiang Production and Construction Corps Hospital from August 2021 to July 2023 were enrolled in this study. These patients were randomly divided into the low-dose group(n=53) and the high-dose group(n=53) according to the dosage of salmon calcitonin. All patients received alendronate as the standard treatment.The low-dose group received injection of salmon calcitonin, 50 IU every two days in the first 2 weeks of treatment, and 50 IU once a week from the 3rd week. The high-dose group received injection of salmon calcitonin, 50 IU/d for the first 2 weeks of treatment, and 100 IU once a week from the 3rd week. All patients were treated continuously for 3 months. The general clinical characteristics, the levels of OST, PINP, beta-isomer of the C-terminal telopeptides of type Ⅰ collagen(β-CTx) and bone mineral density (BMD) before and after the treatment were compared between the two groups. The improvement in bone pain was assessed using the visual analogue score(VAS), and the clinical effectiveness and the incidence of adverse reactions were compared between the two groups. Results After treatment, the levels of serum OST and β-CTx were significantly decreased, and the level of PINP was significantly increased in both groups, especially in the high-dose group(P<0.05). After treatment, the levels of BMD at femoral neck, lumbar spine and hip were significantly increased in both groups, especially in the high-dose group(P<0.05). After treatment, the VAS score was significantly decreased in both groups, especially in the high-dose group(P<0.05). There were no significant differences in the total effective rate and the incidence rate of adverse between the two groups(P>0.05). Conclusions An increased dosage of salmon calcitonin could enhance the therapeutic effectiveness in treating osteoporosis among the elderly patients, and improve bone metabolism, BMD and bone pain with safety.

Key words: aged, osteoporosis, bone metabolism, salmon calcitonin, bone pain

中图分类号:

R 589

孙燕, 张新菊, 阿力·艾拜, 李雁. 不同剂量鲑鱼降钙素治疗老年骨质疏松症病人的临床疗效及安全性研究[J]. 实用老年医学, 2025, 39(4): 362-366.

SUN Yan, ZHANG Xinju, ALI Aibai, LI Yan. Clinical efficacy and safety of different doses of salmon calcitonin in elderly patients with osteoporosis[J]. Practical Geriatrics, 2025, 39(4): 362-366.

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