骨折患者长期卧床骨质改变与降钙素的预防.docVIP

　　骨折患者长期卧床骨质改变与降钙素的预防 【摘要】 目的 探讨青壮年骨折患者长期卧床与骨量丢失、骨强度减低的关系及鲑鱼降钙素的预防作用。 方法 对68 例20～35 岁严重骨折患者，36 例入院即给予鲑鱼降钙素加元素钙 治疗 ，32 例单纯元素钙治疗，持续治疗到患者卧床结束。于入院当时及入院后1、2、3个月测量患者腰椎双能X线骨密度(bone mineral density，BMD)、胫骨超声骨强度(speed of sound，SOS)并检测血清骨钙素(bone glaprotEin，BGP)、尿钙(calcium，Ca)与尿肌酐(creatinie，Cr)。将卧床超过3个月者纳入最终 研究 对象，其中鲑鱼降钙素加元素钙组31 例，单纯元素钙组27 例，共58 例。结果 鲑鱼降钙素加元素钙组，入院后1、2、3个月腰椎BMD与入院时相比差异均无显著性(P＞0.05)；单纯元素钙组，入院后1个月BMD无明显变化，入院后2个月与3个月BMD分别为0.765±0.191和0.598±0.187，显著(或非常显著)低于入院时(P＜0.05或P＜0.01)。胫骨中段SOS检测结果与BMD相似。两组入院后1、2、3个月血清BGP与入院时相比差异均无显著性(P＞0.05)。鲑鱼降钙素加元素钙组，入院后各时间点尿Ca/Cr比值与入院时相比差异均无显著性(P＞0.05)；单纯元素钙组，入院后1个月Ca/Cr比值无明显变化，入院后2个月与3个月尿Ca/Cr比值分别为0.853±0.434和1.011±0.546，显著(或非常显著)高于入院时(P＜0.05或P＜0.01)。结论 青壮年骨折病人长期卧床可引起骨量丢失、骨强度减低，主要由骨吸收引起，鲑鱼降钙素能预防该种骨量丢失与骨强度减低。 【关键词】 骨折；青壮年；卧床；骨密度；骨强度；鲑鱼降钙素 　　Effects of Longterm bed on Loss of Bone Mass and Bone Strength and Prevention of Calcitionin in Patients bed and loss of bone mass and bone strength and the prevention of calcitionin in young patients from hospital admission to end of lying in bed. Patients inated by bone mineral density(BMD) of lumbar， speed of sound(SOS) of tibia， serum osteocalcin(BGP)， urinary calcium(Ca) and urinary creatinine(Cr) in admission and 1，2 and 3 months post admission. 58 patients onths internalized into the final object. There and 27 in calcium. Results There onths postadmission and admission in the group of calcitionin＋calcium. In the group of calcium， the BMD of lumbar has not marked changes in 1 month postadmission， onths postadmission ission(P＜0.05 or P＜0.01). The changes SOS of tibia ilar to the BMD of lumbar. No difference onths postadmission and admission among 2 groups. The ratio of urinary Ca/Cr of 2 and 3 months postadmission ， ission(P＜0.05 or P＜0.01)， onths postadmission and admission in the group of calcitionin＋calcium. Conclusion Longterm bed can cause loss of bone mass and reduction of bone strength， ainly ascribe to bone resorption. Salmon calcitonin can prevent the change of this kind.