胰岛素联合阿仑膦酸钠对2型糖尿病骨质疏松症患者骨代谢的影响

目的:研究胰岛素联合阿仑膦酸钠对2型糖尿病(T2DM)骨质疏松症患者骨代谢的影响。方法:选择从2010年1月到2015年7月在医院治疗的T2DM合并骨质疏松症患者208例纳入本次研究。依照随机数字表法将患者划分成单用胰岛素组(对照1组)、单用二甲双胍组(对照2组)、二甲双胍及阿仑膦酸钠组(对照3组)以及胰岛素及阿仑膦酸钠组(联合组)各52例,各组在常规补钙治疗的基础上分别给予对应治疗措施,比较各组治疗前后骨代谢相关指标,以及各组治疗过程中的不良反应。结果:组内相比,治疗后联合组的骨密度(BMD)、血清骨特异型碱性磷酸酶(BAP)及骨钙素(BGP)明显高于治疗前,人抗酒石酸酸性磷酸酶5b(TRAP-5b)明显低于治疗前,差异有统计学意义(P0.05);而其他三组治疗前后的BMD、BAP、TRAP-5b和BGP相比,差异均不显著(P0.05)。组间相比,治疗后联合组的BMD、BAP及BGP明显高于其他三组,TRAP-5b明显低于其他三组,差异有统计学意义(P0.05)。各组的不良反应总发生率比较,差异均无统计学意义(均P0.05)。结论:利用胰岛素以及阿仑膦酸钠联合治疗T2DM合并骨质疏松症患者,具有较好的疗效,同时还可有效改善其骨代谢指标水平,值得在临床上予以推广。

Influence of Insulin Combined with Alendronate Sodiumon the BoneMetabolismin Treatment of Patients with Type 2 Diabetes MellitusOsteoporosis

Objective:To study influence of insulin combined with alendronate sodiumon the bone metabolismin treatment of patientswith type 2 diabetes mellitus (T2DM)osteoporosis.Methods:208 patients with T2DMosteoporosis in hospital were enrolled in thisstudy from January 2010 to July 2015. Patients were divided into single insulin group (control group 1), single metformin group(controlgroup 2),metformin combined Alendronate Sodiumgroup (control group 3), and insulin combined Alendronate Sodium group(combinedgroup)according to the random number table method, with 52 cases in each group, they were were given corresponding treatment measureson the basis of conventional calcium, compared bone metabolismrelated indicators before and after treatment, as well as the adversereactions during treatment in two groups.Results:Compared in the groups with bone specific alkaline phosphatase (BAP), bone density(BMD)and osteocalcin(BGP)of combined group were significantly higher than before treatment, and tartrate resistant acid phosphatase 5b(TRAP-5b)were significantly lower than before treatment, the differences were statistically significant (P<0.05); While the BMD, BAP,TRAP-5b and BGP in other three groups before and after treatment had no significant difference (P>0.05). Compared between groupswith the BMD, BAP and BGP in the combined group were significantly higher than those in the other three groups, the TRAP-5b wassignificantly lower than the other three groups, the differences were statistically significant (P<0.05). The incidence rate of adverse reactionin four groups had no significant difference (P>0.05).Conclusion:Using insulin combined alendronate sodiumin the treatment of T2DMosteoporosis patients, with good effect, and can also effectively improve the level of bone metabolism, it isworth to be promoted in clinic.