Kanaji Arihiko, Higashi Masaaki, Namisato Masako, Nishio Makoto, Ando Kenichi, Yamada Harumoto
Department of Orthopaedic Surgery, Fujita Health University, Japan
Lepr Rev. 2006 Jun;77(2):147-53.
There is no well-established treatment for osteoporosis in male patients with leprosy, because no clinical trials have examined the efficacy of treatment on bone mineral density (BMD) or fracture incidence in such patients. The purpose of the present study was to evaluate the therapeutic effect on oral administration of risedronate in male osteoporotic patients with leprosy. Twenty-three male patients with leprosy, 63-87 years of age, were randomly divided into two administration groups: R group (risedronate, 2.5 mg/day, daily) and P group (placebo, daily). The BMD of the lumbar spine (L2-L4) was measured by dual-energy X-ray absorptiometry, and urinary cross linked N-telopeptides of type I collagen (NTX) were assessed at baseline, 6 months, and 12 months after treatment. There were no significant differences in age, body mass index, BMD, or urinary NTX levels at baseline between the two groups. In the present study, oral administration of risedronate apparently prevented vertebral fractures by increasing lumbar BMD and caused a significant reduction in urinary NTX levels, while oral administration of placebo did not increase the lumbar BMD and prevent vertebral fractures due to osteoporosis. The above findings suggested that oral administration of risedronate contributed to the prevention of vertebral fractures by suppressing bone resorption and increasing in lumbar BMD in the elderly male patients with leprosy.
对于男性麻风病患者的骨质疏松症,目前尚无成熟的治疗方法,因为尚无临床试验研究过针对此类患者骨矿物质密度(BMD)或骨折发生率的治疗效果。本研究的目的是评估口服利塞膦酸钠对男性麻风病骨质疏松患者的治疗效果。23名年龄在63 - 87岁的男性麻风病患者被随机分为两个给药组:R组(利塞膦酸钠,2.5毫克/天,每日一次)和P组(安慰剂,每日一次)。采用双能X线吸收法测量腰椎(L2 - L4)的骨密度,并在治疗前、治疗后6个月和12个月评估尿I型胶原交联N - 端肽(NTX)水平。两组患者在年龄、体重指数、骨密度或治疗前尿NTX水平方面无显著差异。在本研究中,口服利塞膦酸钠通过增加腰椎骨密度明显预防了椎体骨折,并使尿NTX水平显著降低,而口服安慰剂并未增加腰椎骨密度,也未预防因骨质疏松导致的椎体骨折。上述研究结果表明,口服利塞膦酸钠通过抑制骨吸收和增加老年男性麻风病患者的腰椎骨密度,有助于预防椎体骨折。