NewEngland背诵文选10篇.doc

1.绝经后骨质疏松症妇女中Strontium Ranelate对椎体骨折的影响 The Effects of Strontium Ranelate on the Risk of Vertebral Fracture in Women with Postmenopausal Osteoporosis 　　背景 骨质疏松性结构破坏和骨质脆弱是骨质形成减少而骨质吸收增加的结果。在一项2期临床试验中，strontium ranelate,一种通过增加骨质形成和减少骨质吸收来解除骨质重塑的口服活性药物，已经显示可降低椎体骨折危险而增加骨矿密度。　　方法 为了在一项3期临床试验中评估strontium ranelate对预防椎体骨折的疗效，我们将1649例患有骨质疏松症(低骨矿密度)并至少有一个椎体骨折的绝经后妇女随机分成两组，使她们分别接受每天2g口服strontium ranelate或安慰剂治疗共3年。我们在研究前和研究期间给两组病人都补充钙质和维生素D。每年1次进行椎体X线检查，每6个月1次进行骨矿密度测定。　　结果 Strontium ranelate组比安慰剂组较少病人发生新的椎体骨折，骨折发生危险下降在治疗的第1年中为49%，在3年研究期间为41%(相对危险为0.59，95%可信区间为0.48～0.73)。Strontium ranelate使36个月时的腰椎骨矿密度增加14.4%，股骨颈骨矿密度增加8.3%(两项比较均P＜0.001)。两组之间的严重不良事件发生率没有显著差异。　　结论 采用strontium ranelate治疗绝经后骨质疏松症可使椎体骨折危险早期出现持久下降。　　(N Engl J Med 2004;350:459-68.January 29,2004)王华 译 The Effects of Strontium Ranelate on the Risk of Vertebral Fracture in Women with Postmenopausal Osteoporosis ABSTRACT Background Osteoporotic structural damage and bone fragility result from reduced bone formation and increased bone resorption. In a phase 2 clinical trial, strontium ranelate, an orally active drug that dissociates bone remodeling by increasing bone formation and decreasing bone resorption, has been shown to reduce the risk of vertebral fractures and to increase bone mineral density. 由于骨质形成减少和骨质吸收增加从而导致骨结构性损坏和骨质变脆，在2期临床试验阶段，一种叫雷奈酸锶的口服活性药物可以通过增加骨机质减少骨吸收从而达到解除骨重建的过程。临床试验显示这种药物可以降低椎体骨折的发生率，增加骨质密度。 Methods To evaluate the efficacy of strontium ranelate in preventing vertebral fractures in a phase 3 trial, we randomly assigned 1649 postmenopausal women with osteoporosis (low bone mineral density) and at least one vertebral fracture to receive 2 g of oral strontium ranelate per day or placebo for three years. We gave calcium and vitamin D supplements to both groups before and during the study. Vertebral radiographs were obtained annually, and measurements of bone mineral density were performed every six months. 方法：为了在3期临床实验阶段评估雷奈酸锶在干预椎体骨折的疗效，我们将1649名绝经后骨质疏松症患者并至少有一名椎体骨折的绝经后妇女随机分成两组，时他们每天分别服用2g的口服活性雷奈酸锶或是服用同等