摘要
目的:探讨达格列净联合唑来膦酸治疗老年糖尿病合并骨质疏松症疗效及对患者骨代谢、骨密度水平的影响。方法:选取60例老年糖尿病合并骨质疏松症患者,随机分成对照组与观察组,各30例。对照组接受二甲双胍联合唑来膦酸治疗,观察组在此基础上联合达格列净治疗。治疗6个月比较两组临床疗效、糖代谢、电解质、骨代谢及骨密度水平。结果:治疗6个月后,观察组血糖控制率、骨质疏松症治疗临床有效率均高于对照组(均P<0.05);观察组空腹血糖、餐后2 h血糖、糖化血红蛋白及β-C-末端肽交联水平均显著低于对照组,血磷、钙、25羟基维生素D及Ⅰ型胶原N-段前肽均明显高于对照组(均P<0.05)。治疗6个月后,两组腰椎L2~4、Wards三角区、股骨颈、全髋部骨密度水平均上升(均P<0.05),但两组间比较差异无统计学意义(均P>0.05)。结论:老年糖尿病合并骨质疏松症患者应用达格列净联合唑来膦酸治疗在有效控制患者血糖的同时,能改善骨代谢,能增加骨密度,抑制骨吸收。
Objective:To investigate the efficacy of dapagliflozin combined with zoledronic acid in treatment of elderly diabetic patients with osteoporosis and its effect on bone metabolism and bone mineral density.Methods:A total of 60 elderly diabetic patients with osteoporosis were randomly divided into the control group and the observation group with 30 cases in each group.The control group was treated with metformin combined with zoledronic acid,while the observation group was treated with dapagliflozin on this basis.Six months later,the clinical curative effect,glucose metabolism,electrolytes,bone metabolism and bone mineral density were compared between groups.Results:After 6 months of treatment,the blood glucose control rate and clinical effective rate of osteoporosis treatment in the observation group were higher than those in the control group(all P<0.05);fasting blood glucose,2-hour postprandial blood glucose,glycosylated hemoglobin andβ-C-terminal telopeptide in the observation group were lower than those in the control group,and serum phosphorus,serum calcium,25-hydroxyvitamin D,N-terminal propeptide of type I collagen were higher than those in the control group(all P<0.05);the BMD of lumbar L 2-4,and Wards triangle,femoral neck,total hip in two groups were increased(all P<0.05),but there was no statistically significant difference between two groups(all P>0.05).Conclusion:Dapagliflozin combined with zoledronic acid in the treatment of elderly diabetic patients with osteoporosis can effectively control blood glucose,improve bone metabolism,increase bone mineral density,and inhibit bone resorption.
作者
韦文合
WEI Wenhe(Department of Endocrinology,Hechi People’s Hospital,Hechi 547000,China)
出处
《陕西医学杂志》
CAS
2023年第11期1574-1577,1592,共5页
Shaanxi Medical Journal
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20201032)。
