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目的:观察复方碳酸钙片联合骨化三醇对绝经后骨质疏松症妇女骨密度(BMD)及骨转换指标的影响。方法:采用前瞻性随机对照研究方法,选取年龄55～75岁、绝经期>1年,≥2项骨质疏松性骨折高危因素的女性志愿者116名,随机分为2组。干预组56例,每日给予复方碳酸钙片1片及骨化三醇0.25μg;对照组60例,维持原有生活方式并定期复查。分别于干预前后测量腰椎及髋部BMD、骨转换指标骨碱性磷酸酶(BALP)及抗酒石酸酸性磷酸酶5b(TRACP5b)。结果:干预12个月后,干预组腰椎、股骨颈、大转子及髋部BMD均有明显增加(P<0.01或0.05);而对照组腰椎、股骨颈及大转子BMD、无明显变化(P>0.05),髋部BMD增加0.91%(P<0.05)。干预组腰椎及大转子BMD增加优于对照组(P<0.01),股骨颈及髋部BMD增加无明显差异(P>0.05)。干预组BALP及TRACP5b分别下降23.25%和36.06%(P<0.01);对照组BALP及TRACP5b无明显变化(P>0.05)。组间比较,干预组抑制骨转换优于对照组(P<0.01)。结论:绝经后女性补充复方碳酸钙片和骨化三醇可抑制骨转换,降低骨转换率,增加腰椎及髋部BMD。
Objective: To observe the effects of compound calcium carbonate tablets and calcitriol on bone mineral density (BMD) and bone turnover in postmenopausal women with osteoporosis. Methods: A prospective randomized controlled study was conducted. A total of 116 female volunteers aged 55-75 years, ≥1 year and ≥2 osteoporotic fractures were randomly divided into two groups. In the intervention group, 56 cases were given daily calcium carbonate tablets and calcitriol 0.25μg; control group 60 cases, to maintain the original lifestyle and regular review. BMD of lumbar spine and hip, bone turnover index bone alkaline phosphatase (BALP) and tartrate-resistant acid phosphatase 5b (TRACP5b) were measured before and after intervention. RESULTS: BMD of lumbar spine, femoral neck, greater trochanter and hip were significantly increased in intervention group (P <0.01 or 0.05) after 12 months intervention, while there was no significant difference in BMD of lumbar, femoral neck and greater trochanter in control group > 0.05), hip BMD increased by 0.91% (P <0.05). BMD of lumbar spine and greater trochanter in intervention group was higher than that in control group (P <0.01), but no significant difference was found in BMD of femoral neck and hip (P> 0.05). The levels of BALP and TRACP5b in the intervention group decreased by 23.25% and 36.06%, respectively (P <0.01). There was no significant change in BALP and TRACP5b in the control group (P> 0.05). Compared with the control group, the inhibition of bone turnover in the intervention group was better than that in the control group (P <0.01). Conclusion: Supplementation of compound calcium carbonate tablets and calcitriol in postmenopausal women can inhibit bone turnover, reduce bone turnover and increase BMD of lumbar spine and hip.