Kunisaki Chikara, Tanaka Yusaku, Kosaka Takashi, Miyamoto Hiroshi, Sato Sho, Suematsu Hideaki, Yukawa Norio, Sato Kei, Izumisawa Yusuke, Akiyama Hirotoshi, Taguri Masataka, Yamanaka Takeharu, Endo Itaru
Department of Surgery, Gastroenterological Center, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
Digestion. 2017;95(2):162-171. doi: 10.1159/000458755. Epub 2017 Feb 18.
BACKGROUND/AIMS: Osteoporosis is found to have high prevalence after gastrectomy and therefore, it is important to prevent this condition by means of effective medication, such as alendronate sodium hydrate.
A total number of 48 gastric cancer patients diagnosed with osteoporosis after R0 gastrectomy was registered in this study between December 2013 and August 2014. Twenty-three patients received intravenous (i.v.) alendronate sodium hydrate and 25 patients received the drug in an oral jelly form. Serological and urinary examinations related to bone metabolism and bone mineral density (BMD) were performed periodically and the results obtained from the 2 groups were compared.
BMD increased, serum levels of bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase-5b, and the urine level of urine N-terminal telopeptide decreased with time in both groups. However, the serum Ca level did not change. Two-way analysis of variance revealed no significant differences in these factors between the 2 groups.
It is essential to prevent both forms of osteoporosis by using alendronate sodium hydrate after gastrectomy for gastric cancer. A prospective, randomized, controlled trial in many patients following long duration should be conducted to clarify the benefits of i.v. alendronate sodium hydrate.
背景/目的：研究发现，胃切除术后骨质疏松的患病率较高，因此，通过使用阿仑膦酸钠水合物等有效药物预防这种情况很重要。
2013年12月至2014年8月期间，本研究共纳入48例R0胃切除术后诊断为骨质疏松的胃癌患者。23例患者接受静脉注射阿仑膦酸钠水合物，25例患者接受口服凝胶剂型药物。定期进行与骨代谢和骨密度（BMD）相关的血清学和尿液检查，并比较两组的检查结果。
两组患者的骨密度均随时间增加，骨特异性碱性磷酸酶和抗酒石酸酸性磷酸酶-5b的血清水平以及尿N末端肽的尿水平均下降。然而，血清钙水平没有变化。双向方差分析显示两组之间在这些因素上没有显著差异。
胃癌胃切除术后使用阿仑膦酸钠水合物预防两种类型的骨质疏松至关重要。应开展一项针对众多患者的长期前瞻性随机对照试验，以阐明静脉注射阿仑膦酸钠水合物的益处。
