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阿仑膦酸盐治疗绝经后骨质疏松症的效果。

The effect of alendronate in the treatment of postmenopausal osteoporosis.

作者信息

Rozkydal Z, Janicek P

机构信息

Ist Orthopaedic Department, St. Anna's Hospital, Masarykiensis University, Brno, Czech Republic.

出版信息

Bratisl Lek Listy. 2003;104(10):309-13.

Abstract

OBJECTIVES

The aim of the study was the evaluation of the effect of alendronate in the treatment of postmenopausal osteoporosis on subjective criteria and on bone mineral density after two years.

MATERIAL AND METHODS

The authors collected data from 44 women by questionaire and analysed the data from DEXA examination. The patients were given Fosamax 10 mg and calcium 500 mg per day in the years 2001-2002.

RESULTS

The compliance of alendronate was good in 42 women (95.5%). 15 patients were very satisfied with the treatment, 22 were satisfied and 5 patients claimed no improvement at the end of the study. A positive effect of the treatment was seen in 37 patients (88.1%). 21 patients claimed to have no pain and 15 patients suffered mild intermitent pain at the end of the study. 24 patients used no analgetics and 9 patients used them irregularly. 11 patients claimed to have normal activity and 22 patients had mildly diminished activity in daily life. The authors encountered no symptomatic vertebral or nonvertebral fracture during the study. The mean BMD in the lumbar spine improved in T score by 0.38 SD after one year and 0.35 SD after the second year. The mean BMD has improved in the neck region in T score by 0.21 SD after the first year and 0.21 SD after the second year. The mean BMD in lumbar spine has improved in Z score by 0.31 SD after one year and 0.02 SD after the second year. The mean BMD in the neck region has improved in Z score by 0.31 SD after the first year and 0.16 SD after the second year. The mean change of bone mineral density in lumbar spine was +4.17% after the first years and +4.19% after the second year. The mean change of BMD in the femoral neck region was +4.46% after the first years and + 3.71% after the second year. According to student t-test all the data of increased BMD were statisticaly significant at the 5% level of the significance (p < 0.05).

CONCLUSION

Alendronate therapy significantly reduced the pain and the need for analgesics. It improved the daily activity and mobility of the spine in the patients with postmenopausal osteoporosis. It resulted in a positive change of BMD in vertebral region of +8.36% and +8.17% in the femoral neck region after two years. The fracture risk in vertebral region was diminished by 31% and in the femoral neck region by 38% at the end of the study. (Tab. 11, Ref. 14.).

摘要

目的

本研究旨在评估阿仑膦酸盐治疗绝经后骨质疏松症两年后的主观标准效果及骨密度变化。

材料与方法

作者通过问卷调查收集了44名女性的数据,并分析了双能X线吸收法(DEXA)检查的数据。2001 - 2002年期间,患者每天服用10毫克福善美和500毫克钙。

结果

42名女性(95.5%)对阿仑膦酸盐的依从性良好。研究结束时,15名患者对治疗非常满意,22名患者满意,5名患者称无改善。37名患者(88.1%)治疗有积极效果。研究结束时,21名患者称无疼痛,15名患者有轻度间歇性疼痛。24名患者未使用镇痛药,9名患者不定期使用。11名患者称日常活动正常,22名患者日常生活活动轻度受限。研究期间作者未遇到有症状的椎体或非椎体骨折。腰椎骨密度T值在第一年提高了0.38标准差,第二年提高了0.35标准差。颈部骨密度T值在第一年提高了0.21标准差,第二年提高了0.21标准差。腰椎骨密度Z值在第一年提高了0.31标准差,第二年提高了0.02标准差。颈部骨密度Z值在第一年提高了0.31标准差,第二年提高了0.16标准差。腰椎骨密度第一年平均变化为 +4.17%,第二年为 +4.19%。股骨颈区域骨密度第一年平均变化为 +4.46%,第二年为 +3.71%。根据学生t检验,所有骨密度增加的数据在5%显著性水平上具有统计学意义(p < 0.05)。

结论

阿仑膦酸盐治疗显著减轻了疼痛和对镇痛药的需求。它改善了绝经后骨质疏松症患者的日常活动和脊柱活动度。两年后,椎体区域骨密度有正向变化,为 +8.36%,股骨颈区域为 +8.17%。研究结束时,椎体区域骨折风险降低了31%,股骨颈区域降低了38%。(表11,参考文献14。)

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