2023 年第 5 期 第 18 卷

阿仑膦酸钠治疗骨质疏松对骨密度与血清Klotho蛋白水平的影响

Effects of alendronate sodium on bone mineral density and serum Klotho protein level in patients with osteoporosis

作者：马广丽1臧巧源2杨青2王庆普3

英文作者：Ma Guangli1 Zang Qiaoyuan2 Yang Qing2 Wang Qingpu3

单位：1北京市隆福医院门诊办公室，北京100010；2北京市隆福医院药剂科，北京100010；3北京中医药大学第三附属医院筋伤科，北京100029

英文单位：1Outpatient Office Beijing Longfu Hospital Beijing 100010 China; 2Department of Pharmacy Beijing Longfu Hospital Beijing 100010 China; 3Department of Muscle and Traumatology Beijing University of Chinese Medicine Third Affiliated Hospital Beijing 100029 China

关键词：骨质疏松；阿仑膦酸钠；骨密度；血清Klotho蛋白

英文关键词：Osteoporosis;Alendronatesodium;Bonemineraldensity;SerumKlothoprotein

• 摘要：

• 目的 探讨阿仑膦酸钠治疗骨质疏松对骨密度与血清Klotho蛋白水平的影响。方法 选择2020年6月至2021年12月就诊于北京市隆福医院的150例骨质疏松患者，按照随机数字表法分成对照组与观察组，每组75例。对照组予以常规治疗，观察组予以常规治疗+阿仑膦酸钠治疗，均治疗6个月。比较2组治疗前后骨密度（L1～4椎体、股骨颈、Ward′s三角区、大转子）、骨转换指标（骨碱性磷酸酶、Ⅰ型胶原N末端肽、骨钙素）、血清Klotho蛋白水平、临床疗效和不良反应发生情况。结果  2组治疗后L1～4椎体、股骨颈、Ward′s三角区、大转子的骨密度均高于治疗前，且观察组均高于对照组（均P＜0.05）。2组治疗后骨碱性磷酸酶、Ⅰ型胶原N末端肽、骨钙素水平均高于治疗前，且观察组均高于对照组（均P＜0.05）。对照组与观察组治疗后血清Klotho蛋白水平均低于治疗前［（737±45）ng/L比（884±50）ng/L、（673±41）ng/L比（884±51）ng/L］，且观察组治疗后血清Klotho蛋白水平低于对照组（均P＜0.05）。观察组总有效率高于对照组［93.3%（70/75）比82.7%（62/75）］（P=0.044）。2组不良反应发生率比较差异无统计学意义（P=0.754）。结论   阿仑膦酸钠治疗骨质疏松的效果较好，可改善患者骨密度、骨转换指标，降低血清Klotho蛋白水平，且不良反应少，有效性与安全性均较好。

• Objective  To investigate the effects of alendronate on bone mineral density(BMD) and serum Klotho protein level in patients with osteoporosis. Methods From June 2020 to December 2021, 150 patients with osteoporosis admitted to Beijing Longfu Hospital were selected. They were divided into the control group and the observation group according to the random number table method, with 75 cases in each group. The control group were treated with conventional therapy, and the observation group were treated with conventional therapy and alendronate sodium, all treated for 6 months. BMD (L1-4 vertebral body, femoral neck, Ward′s triangle, greater trochanter), bone turnover index (bone alkaline phosphatase, N-terminal peptide of type Ⅰ collagen, osteocalcin), serum Klotho protein level, clinical efficacy, adverse reactions were compared before and after treatment in the two groups. ResultsAfter treatment, the BMD of L1-4 vertebral body, femoral neck, Ward′s triangle and greater trochanter in the two groups were higher than those before treatment, and those in the observation group were higher than those in the control group (all P＜0.05). After treatment, the levels of bone alkaline phosphatase, N-terminal peptide of type Ⅰ collagen and osteocalcin in the two groups were higher than those before treatment, and those in the observation group were higher than those in the control group (all P＜0.05). The levels of serum Klotho protein in the control group and the observation group after treatment were lower than those before treatment ［(737±45)ng/L vs (884±50)ng/L, (673±41)ng/L vs (884±51)ng/L］, and those in the observation group after treatment were lower than those in the control group (all P＜0.05). The total effective rate in the observation group was higher than that in the control group ［93.3%(70/75) vs 82.7%(62/75)］(P=0.044). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P=0.754). Conclusions Alendronate sodium is effective in the treatment of osteoporosis. It can improve the BMD and bone turnover index of patients, reduce the level of serum Klotho protein, and has less adverse reactions. It is effective and safe.