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硝酸异山梨酯和阿仑膦酸钠治疗绝经后骨质疏松症的比较评价。

Comparative evaluation of isosorbide mononitrate and alendronate in management of postmenopausal osteoporosis.

机构信息

Department of Obstetrics and Gynecology, Pt. B.D. Sharma PGIMS, H. No. 6/9J, Medical Campus, Rohtak, 124001 Haryana, India.

出版信息

Arch Gynecol Obstet. 2012 Apr;285(4):1019-23. doi: 10.1007/s00404-011-2095-3. Epub 2011 Oct 5.

Abstract

BACKGROUND

Osteoporosis, a skeletal disorder that adversely affects bone strength , is common among postmenopausal women primarily due to reduced ovarian estrogens.

PURPOSE

The present study was taken up to evaluate the role of isosorbide mononitrate (IMN) in the management of postmenopausal osteoporosis and to compare its efficacy with that of alendronate.

METHODS

This prospective systematic randomized study was conducted on 90 postmenopausal women with lumbar spine BMD >2.5 SD below the young adult reference range. The participants received either Tab Alendronate 70 mg orally, once weekly (Group I) or Tab IMN 40 mg orally once daily (Group II) for 9 months, in addition to 500 mg of oral calcium daily. The BMD of the lumbar spine was measured using DEXA scan at enrolment and after 9 months. The data was analyzed by Student's t test and Chi-square test.

RESULTS

The mean baseline BMD was 0.67 + 0.097 and 0.68 + 0.067 g/cm(2) in Group I and II, respectively. An increase of 11.94% in the mean BMD was noted after 9 months of treatment with alendronate as against 8.82% with IMN. Headache, flushing and palpitations in Group II and nausea, epigastric pain and heart burn in Group I were the most common adverse effects.

CONCLUSION

IMN has a beneficial effect on bone turnover in cases of postmenopausal osteoporosis and that the effect is comparable to that of alendronate. IMN is a promising and safe alternative to alendronate for the management of postmenopausal osteoporosis.

摘要

背景

骨质疏松症是一种骨骼疾病,会降低骨强度,绝经后妇女中较为常见,主要是由于卵巢雌激素减少所致。

目的

本研究旨在评估单硝酸异山梨酯(ISMN)在绝经后骨质疏松症治疗中的作用,并将其与阿仑膦酸钠进行疗效比较。

方法

本前瞻性系统随机研究纳入了 90 例腰椎骨密度(BMD)低于年轻成人参考值 2.5 个标准差的绝经后妇女。参与者接受阿仑膦酸钠 70mg 口服,每周一次(I 组)或 ISMN 40mg 口服,每日一次(II 组),同时每日口服 500mg 钙,共 9 个月。在入组时和 9 个月后使用 DEXA 扫描测量腰椎 BMD。采用 Student's t 检验和卡方检验进行数据分析。

结果

I 组和 II 组的平均基线 BMD 分别为 0.67+0.097 和 0.68+0.067g/cm²。阿仑膦酸钠治疗 9 个月后,平均 BMD 增加了 11.94%,而 ISMN 组增加了 8.82%。ISMN 组头痛、潮红和心悸,I 组恶心、上腹痛和胃灼热是最常见的不良反应。

结论

ISMN 对绝经后骨质疏松症的骨转换有有益作用,其效果与阿仑膦酸钠相当。ISMN 是治疗绝经后骨质疏松症的一种有前途且安全的阿仑膦酸钠替代药物。

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