Objective To explore the changes of bone mineral density (BMD) and bone markers in senile osteoporosis patients treated with teriparatide,and evaluate the improvement on quality of life (QOL) as well as the clinical significance. Methods Forty-five senile osteoporosis inpatients were treated with 20 μg of teriparatide for one year. BMD and bone markers were detected before treatment and also in the third,sixth and twelfth month during treatment.The level of numerical rating scale (NRS) and QOL were assessed. Results The NRS before treatment was (4.96±2.25) , and those after treatment of 3, 6 and 12 months were(2.84±1.41), (1.56±1.16) and (1.36±1.00), respectively (P<0.01). The total scores of SF-36 significantly increased after treatment (P<0.01). After treatment of 3, 6 and 12 months, BMD of lumbar vertebra had increased 7.7%, 12.3% and 15.4%, respectively; that of femoral neck had increased 3.0%, 6.1% and 7.6%, respectively; and that of intertrochanteric bone had increased 5.7%, 8.6% and 10.0%, respectively. Meanwhile, the serum levels of osteocalcin, bone alkaline phosphatase and N terminal propeptide of type I procollagen were significantly higher than those before treatment (P<0.01), nevertheless beta collagen cross-linked C-terminal peptide (β-CTX) only significantly decreased at the 12th month after treatment (P<0.05). Conclusion Chronic teriparatide therapy could significantly relieve bone pain,improve the quality of life and increase lumbar vertebra BMD in senile osteoporosis.
Key words:
Teriparatide
;
Osteoporosis
;
Bone mineral density
;
Bone markers
;
Quality of life
骨质疏松症是一种退化性疾病,已成为人类的重要健康问题, 患病风险随着年龄增长而增加。骨质疏松症是导致老年人脆性骨折的一个关键危险因素。骨质疏松症的患者存在骨痛、疲软、骨折以及生活质量下降等临床表现。骨质疏松的治疗方法可通过调节骨吸收和骨形成以达到减少或逆转骨重建的负平衡。甲状旁腺激素的生理学作用包括直接作用于成骨细胞刺激骨骼形成,间接增加肠道钙的吸收,增加肾小管钙的重吸收和增强磷酸盐在肾脏的排泄。特立帕肽是重组人内源性甲状旁腺激素的活性片段(1-34),是第一个用于临床的有促进骨形成的治疗骨质疏松症的药物,可更早增加骨形成,其幅度大于骨吸收,对骨重建平衡有积极的作用,它可以增加骨密度,改善骨微结构和强度,并减少骨折的发生[1-3]。目前国内外对特立帕肽治疗骨质疏松症,主要用于有骨折高发风险的绝经后妇女骨质疏松症的治疗,主要研究集中于对骨密度(bone mineral density,BMD)的增加和骨折的减少[4]。老年性骨质疏松症是原发性骨质疏松的Ⅱ型,目前特立帕肽治疗老年性骨质疏松症的文献不多,研究的时间也较短,不能反映出特立帕肽治疗老年性骨质疏松症的真实疗效和作用[5]。本研究系统评估特立帕肽对老年性骨质疏松症患者BMD和骨标志物的影响以及生活质量的改变以及临床意义。
表3
特立帕肽治疗老年性骨质疏松症治疗前后SF-36得分变化
Tab.3
Changes of the patients’ SF-36 scores before and after teriparatide therapy for senile osteoporosis 分,x¯±s,n=45
时间
SF-36总分
GH
BP
PF
SF
VT
RE
RP
MH
治疗前
76.65±12.06
10.66±3.56
4.66±1.77
16.56±3.58
4.62±1.65
12.05±4.25
4.65±1.25
4.23±0.62
19.23±3.65
治疗3个月
83.34±13.35*1
12.34±3.58*1
5.60±1.81*1
19.06±3.68*1
5.10±1.70
12.35±4.65
5.17±1.33
4.68±0.82*1
19.56±3.74
治疗6个月
92.44±15.25*2
15.34±3.50*2
5.90±1.83*1
22.06±3.72*2
5.40±1.80
13.35±5.35
5.37±1.43
5.45±0.65*2
19.56±3.85
治疗12个月
96.79±15.35*2
15.56±3.56*2
6.00±1.90*1
23.20±3.85*2
5.52±1.75*1
13.76±5.66*1
5.31±1.45*1
5.72±0.68*2
19.80±4.32
Comparison with the level before treatment, *1P<0.05,*2P<0.01
与治疗前比较,*1P<0.05,*2P<0.01
表3
特立帕肽治疗老年性骨质疏松症治疗前后SF-36得分变化
Tab.3
Changes of the patients’ SF-36 scores before and after teriparatide therapy for senile osteoporosis 分,x¯±s,n=45
2.4 血清骨代谢标志物的变化
治疗3,6及12个月后,患者血清骨钙素(osteocalcin,OC)、骨碱性磷酸酶(bone alkaline phosphatase,BAP)和Ⅰ型前胶原N-端前肽(N terminal propeptide of type I procollagen,PINP)较治疗前呈持续升高趋势(P<0.01)。而β型胶原交联C端肽(beta collagen cross-linked C-terminal peptide,β-CTX)降低(P<0.05)。见表4。
表4
Tab.4
表4
表4
患者治疗前后骨标志物变化
Tab.4
Changes of the patients’ bone markers before and after treatment x¯±s,n=45
时间
OC
β-CTX
BAP
PINP
钙含量/ (mmol·L-1)
(ng·mL-1)
治疗前
20.3±3.5
0.795±0.453
9.36±4.32
47.6±20.5
2.16±0.12
治疗3个月
25.4±2.5*2
0.654±0.510
14.57±7.43*2
105.4±30.5*2
2.24±0.41
治疗6个月
29.4±3.5*2
0.553±0.403
16.52±8.94*2
125.4±33.5*2
2.20±0.32
治疗12个月
30.4±4.5*2
0.536±0.324*1
16.81±8.36*2
130.4±24.5*2
2.12±0.26
Comparison with the level before treatment,*1P<0.01,*2P<0.05
与治疗前比较,*1P<0.01,*2P<0.05
表4
患者治疗前后骨标志物变化
Tab.4
Changes of the patients’ bone markers before and after treatment x¯±s,n=45
MCCLUNG MR, SAN MARTINJ, MILLER PD,et al.Opposite bone remodeling effects of teriparatide and alendronate in increasing bone mass[J]. Arch Intern Med, 2005, 165(15):1762-1768.
Abstract BACKGROUND: Antiresorptive agents for the treatment of osteoporosis suppress bone remodeling and reestablish bone turnover at a lower rate to reduce bone loss. Recombinant teriparatide (human parathyroid hormone 1-34) stimulates bone formation, increases bone mass, and improves bone microarchitecture. We contrasted the effects of once-daily doses of 20 mug of teriparatide and 10 mg of alendronate sodium on bone mineral density (BMD) and markers of bone turnover. METHODS: Markers of bone turnover and areal BMD were assessed in 203 postmenopausal women with osteoporosis in an 18-month randomized parallel double-blind study; volumetric BMD was measured in a subset of women. RESULTS: Teriparatide significantly increased markers of bone turnover that peaked at 6 months (serum procollagen type I N-terminal propeptide, 218%, and urinary N-telopeptide corrected for creatinine, 58%; P<.001); alendronate significantly decreased the markers at 6 months (-67% and -72%, respectively; P<.001). At 18 months, areal and volumetric spine BMDs were significantly higher with teriparatide than with alendronate (10.3% vs 5.5% [P<.001] and 19.0% vs 3.8% [P<.01], respectively). Areal femoral neck BMD was significantly higher than baseline in the teriparatide and alendronate groups (3.9% and 3.5%, respectively). There were no significant differences in trabecular femoral neck BMD between the teriparatide and alendronate groups (4.9% and 2.2%, respectively). Cortical volumetric femoral neck BMD was significantly different between the teriparatide and alendronate groups (-1.2% and 7.7%, respectively; P = .05). CONCLUSION: Two distinct options for the management of osteoporosis lead to increases in BMD by opposite mechanisms of action on bone remodeling.
BISLEV LS, SIKJAERT, REJNMARKL.Effects on calcium homeostasis of changing PTH replacement therapy of postoperative hypoparathyroidism from intact PTH to teriparatide: a case series[J]. Calcif Tissue Int, 2014,95(4):374-381.
The objective of this study was to assess the effect on calcium homeostasis of changing PTH replacement therapy (PTH-RT) from intact PTH (PTH 1–84 ) to teriparatide (PTH 1–34 ). This study is a consecutive case series. All patients with postoperative hypoparathyroidism who changed medication from PTH 1–84 (1000208g) to PTH 1–34 (200208g) were included. Plasma ionized calcium, daily dose of 1α-hydroxylated-vitamin D metabolites alfacalcidol, calcium, TSH and PTH was collected. Eight patients (women02=028802%) with a mean age of 5402±021202years and a duration of hypoPT of 1302±02602years were included. Before initiation of PTH 1–84 , the mean daily dose of alfacalcidol was 1.902±021.10208g/d and calcium supplements were 1,55002±0270502mg. Alfacalcidol dose was reduced with 8802±022902% ( p 02<020.01) after 6 months of PTH 1–84 treatment and terminated in six patients. Calcium levels were reduced with 7802±023602% ( p 02=020.02) to 27302±0235302mg/d and stopped in five patients. Six patients received 1000208g PTH 1–84 daily, the seventh 2 out of 3 days and the last every second day. When changing from PTH 1–84 to PTH 1–34 , plasma ionized calcium initially dropped and the demand for supplements increased. Alfacalcidol was resumed in five patients; mean daily dose increased to 1.5002±021.560208g/d, ( p 02=020.02) and calcium increased to 32902±0236802mg/d, ( p 02=020.72). Five patients received 200208g PTH 1–34 a day, two patients twice-a-day and one 20/400208g/d alternately. Compared with PTH 1–34 , PTH 1–84 has a longer plasma half-life and a higher calcemic response. We have shown a need for higher doses of alfacalcidol and calcium supplements to maintain normal serum calcium when treated with PTH 1–34 compared to PTH 1–84 and in some a need for more than one daily PTH 1–34 dose.
ERIKSEN EF, KEAVENY TM, GALLAGHER ER, et al.Literature review: the effects of teriparatide therapy at the hip in patients with osteoporosis[J]. Bone,2014,67:246-256.
Teriparatide is a skeletal anabolic treatment for patients with at high risk for fracture. Because adequate clinical trials have not yet been conducted to assess the efficacy of teriparatide for reducing the risk of hip fracture, we review here the literature regarding how treatment with teriparatide affects the hip in patients with . Teriparatide increases cancellous bone volume, improves bone architecture, and - uniquely among treatments - increases cortical thickness and cortical porosity. By bone scan and emission tomography, teriparatide increases throughout the skeleton, including the hip. Consistent with these findings, studies using dual-energy X-ray absorptiometry and quantitative computed tomography for longitudinal assessment of changes at the hip have consistently shown increases in areal and volumetric bone mineral density, cortical thickness, and finite element-estimated hip strength in patients treated with teriparatide. Finally, in clinical fracture-outcome trials, treatment with teriparatide has been shown to reduce the risk of nonvertebral fracture, a composite endpoint that includes hip fracture. Taken together, this body of evidence suggests that teriparatide positively affects the hip in patients with .
LJUNGGRENO, BARRETTA, STOYKOVI, et al.Effective osteoporosis treatment with teriparatide is associated with enhanced quality of life in postmenopausal women with osteoporosis: the European Forsteo Observational Study[J]. BMC Musculoskelet Disord,2013,14:251.
Background To describe changes in health-related quality of life (HRQoL) of postmenopausal women with osteoporosis treated with teriparatide for up to 18 months and followed-up for a further 18 months, and to assess the influence of recent prior and incident fractures. Methods The European Forsteo Observational Study (EFOS) is an observational, prospective, multinational study measuring HRQoL using the EQ-5D. The primary objective was to assess changes in HRQoL during 36 months in the whole study population. A secondary post-hoc analysis examined fracture impact on HRQoL in four subgroups classified based on recent prior fracture 12 months before baseline and incident clinical fractures during the study. Changes from baseline were analysed using a repeated measures model. Results Of the 1581 patients, 48.4% had a recent prior fracture and 15.6% of these patients had an incident fracture during follow-up. 10.9% of the 816 patients with no recent prior fracture had an incident fracture. Baseline mean EQ-VAS scores were similar across the subgroups. In the total study cohort (n???=???1581), HRQoL (EQ-VAS and EQ-5D index scores) improved significantly from baseline to 18 months and this improvement was maintained over the 18-month post-teriparatide period. Improvements were seen across all five EQ-5D domains during teriparatide treatment that were maintained after teriparatide was discontinued. Subjects with incident clinical fractures had significantly less improvement in EQ-VAS than those without incident fractures. Recent prior fracture did not influence the change in EQ-VAS during treatment. Conclusions EFOS is the first longitudinal study in women with severe postmenopausal osteoporosis in the real world setting to show a substantial improvement in HRQoL during teriparatide treatment that was sustained during subsequent treatment with other medications. The increase in HRQoL was lower in the subgroups with incident fracture but was not influenced by recent prior fracture. The results should be interpreted in the context of the design of an observational study.
KYVERNITAKISI, SAEGERU, ZILLERV, et al.The effect of age, sex hormones and bone turnover markers on calcaneal quantitative ultrasonometry in healthy German men[J]. J Clin Densitom, 2013,16(3):320-328.
The aim of this cross-sectional study was to determine the age-dependent variations of calcaneal quantitative ultrasonometry (QUS) and the association with sex hormones and biochemical bone turnover markers in a large sample of unselected healthy German men. Bone measurements are expected to behave differently among men and women. The speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness index (SI) of the os calcaneus were measured in 506 German men aged 20-79 yr (mean age: 45.7 yr). Additionally, follicle-stimulating hormone (FSH), luteinizing hormone (LH), , , , dehydroepiandrosterone (DHEA-S), sex globulin () as well as N-terminal propeptide of procollagen type I (PINP), C-terminal telopeptide of type I (ICTP), , bone-specific , and CrossLaps were measured with standardized essays and correlated with the QUS results. The QUS results comprised an overall change of 12.4%, 3.2%, and 23.2% for BUA, SOS, and SI, respectively, between the 20-29 and 70-79 yr age groups (p 鈮 0.001). The annual rate of the age-related differences was 0.33% (standard deviation [SD]: 0.31), 0.06% (SD: 0.08), and 0.53% (SD: 0.56) for BUA, SOS, and SI, respectively. and DHEA-S were significantly associated with QUS parameters and increasing age, whereas showed an age-related increase and was inversely related with QUS values (p < 0.05). Bone turnover markers present lower values gradually, and we found a significant correlation between carboxy-terminal crosslinks (), (OC), bone (), and QUS variables (p < 0.05).
HERRMANNW, OBEIDR, SCHORRH, et al.Enhanced bone metabolism in vegetarians-the role of vitamin B12 deficiency[J]. Clin Chem Lab Med,2009, 47(11):1381-1387.
Background: Vitamin B12 deficiency and bone fractures are common in vegetarians. However, a direct relationship between vitamin B12 status and bone metabolism in vegetarians has not been tested sufficiently. Methods: Our study included 96 vegetarians (23 German vegans, and 54 German and 19 Indian lacto-, lacto-ovo-vegetarians) and 89 omnivores (Germans and Asian-Indian immigrants in Oman). Bloo...
SZULCP, GARNEROP, MUNOZF, et al.Cross-sectional evaluation of bone metabolism in men[J]. J Bone Miner Res,2001,16(9):1642-1650.
There are relatively few data concerning age-related changes of bone turnover in men. The aim of the study was to evaluate age-related changes of the levels of serum and urinary biochemical markers of bone metabolism in a large cohort of 934 men aged 19-85 years and to investigate their association with bone mineral density (BMD). Bone formation was evaluated using serum levels of osteocalcin (OC), bone alkaline phosphatase (BAP), and N-terminal extension propeptide of type I collagen (PINP). Bone resorption was evaluated by measurement of urinary excretion of beta-isomerized C-terminal telopeptide of collagen type I beta-CTX) of free deoxypyridinoline (fDpyr) and total Dpyr (tDPyr) and of the serum level of beta-CTX. Levels of biochemical bone markers were very high in young men and decreased rapidly until the age of 40 years and then more slowly until 60 years of age. After the age of 60 years, markers of bone formation remained stable while resorption markers showed a moderate and variable increase with aging. Serum and urinary beta-CTX levels were elevated only in about 5% of elderly men. The age-related increase of urinary excretion of tDpyr and of its free and peptide-bound fractions was related to the presence of elevated levels in a subgroup of about 15% of elderly men. Before 60 years of age, levels of biochemical bone markers were not correlated with BMD, whereas after 60 years of age, they were correlated negatively with BMD. After adjustment for age and body weight, BMD in men with the highest levels of biochemical bone markers (i.e., in the upper quartile) was 1.8-12.5% (i.e., 0.25-0.89 SD) lower than in men with levels of biochemical bone markers in the lowest quartile. In conclusion, bone turnover in men is high in young adults and decreases to reach a nadir at 55-60 years of age. After the age of 60 years, bone resorption markers--but not bone formation markers--increase in some men and are associated with lower BMD, suggesting that this imbalance is
CRANDALLCJ, NEWBERRY SJ, DIAMANTA, et al.Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review[J]. Ann Intern Med,2014,161(10):711-723.
Osteoporosis is a major contributor to the propensity to fracture among older adults, and various pharmaceuticals are available to treat it.To update a review about the benefits and harms of pharmacologic treatments used to prevent fractures in adults at risk.Multiple computerized databases were searched between 2 January 2005 and 4 March 2014 for English-language studies.Trials, observational studies, and systematic reviews.Duplicate extraction and assessment of data about study characteristics, outcomes, and quality.From more than 52000 titles screened, 315 articles were included in this update. There is high-strength evidence that bisphosphonates, denosumab, and teriparatide reduce fractures compared with placebo, with relative risk reductions from 0.40 to 0.60 for vertebral fractures and 0.60 to 0.80 for nonvertebral fractures. Raloxifene has been shown in placebo-controlled trials to reduce only vertebral fractures. Since 2007, there is a newly recognized adverse event of bisphosphonate use: atypical subtrochanteric femur fracture. Gastrointestinal side effects, hot flashes, thromboembolic events, and infections vary among drugs.Few studies have directly compared drugs used to treat osteoporosis. Data in men are very sparse. Costs were not assessed.Good-quality evidence supports that several medications for bone density in osteoporotic range and/or preexisting hip or vertebral fracture reduce fracture risk. Side effects vary among drugs, and the comparative effectiveness of the drugs is unclear.Agency for Healthcare Research and Quality and RAND Corporation.
Opposite bone remodeling effects of teriparatide and alendronate in increasing bone mass
1
2005
... 骨质疏松症是一种退化性疾病,已成为人类的重要健康问题, 患病风险随着年龄增长而增加.骨质疏松症是导致老年人脆性骨折的一个关键危险因素.骨质疏松症的患者存在骨痛、疲软、骨折以及生活质量下降等临床表现.骨质疏松的治疗方法可通过调节骨吸收和骨形成以达到减少或逆转骨重建的负平衡.甲状旁腺激素的生理学作用包括直接作用于成骨细胞刺激骨骼形成,间接增加肠道钙的吸收,增加肾小管钙的重吸收和增强磷酸盐在肾脏的排泄.特立帕肽是重组人内源性甲状旁腺激素的活性片段(1-34),是第一个用于临床的有促进骨形成的治疗骨质疏松症的药物,可更早增加骨形成,其幅度大于骨吸收,对骨重建平衡有积极的作用,它可以增加骨密度,改善骨微结构和强度,并减少骨折的发生[1-3].目前国内外对特立帕肽治疗骨质疏松症,主要用于有骨折高发风险的绝经后妇女骨质疏松症的治疗,主要研究集中于对骨密度(bone mineral density,BMD)的增加和骨折的减少[4].老年性骨质疏松症是原发性骨质疏松的Ⅱ型,目前特立帕肽治疗老年性骨质疏松症的文献不多,研究的时间也较短,不能反映出特立帕肽治疗老年性骨质疏松症的真实疗效和作用[5].本研究系统评估特立帕肽对老年性骨质疏松症患者BMD和骨标志物的影响以及生活质量的改变以及临床意义. ...
Effects on calcium homeostasis of changing PTH replacement therapy of postoperative hypoparathyroidism from intact PTH to teriparatide: a case series
2014
Literature review: the effects of teriparatide therapy at the hip in patients with osteoporosis
1
2014
... 骨质疏松症是一种退化性疾病,已成为人类的重要健康问题, 患病风险随着年龄增长而增加.骨质疏松症是导致老年人脆性骨折的一个关键危险因素.骨质疏松症的患者存在骨痛、疲软、骨折以及生活质量下降等临床表现.骨质疏松的治疗方法可通过调节骨吸收和骨形成以达到减少或逆转骨重建的负平衡.甲状旁腺激素的生理学作用包括直接作用于成骨细胞刺激骨骼形成,间接增加肠道钙的吸收,增加肾小管钙的重吸收和增强磷酸盐在肾脏的排泄.特立帕肽是重组人内源性甲状旁腺激素的活性片段(1-34),是第一个用于临床的有促进骨形成的治疗骨质疏松症的药物,可更早增加骨形成,其幅度大于骨吸收,对骨重建平衡有积极的作用,它可以增加骨密度,改善骨微结构和强度,并减少骨折的发生[1-3].目前国内外对特立帕肽治疗骨质疏松症,主要用于有骨折高发风险的绝经后妇女骨质疏松症的治疗,主要研究集中于对骨密度(bone mineral density,BMD)的增加和骨折的减少[4].老年性骨质疏松症是原发性骨质疏松的Ⅱ型,目前特立帕肽治疗老年性骨质疏松症的文献不多,研究的时间也较短,不能反映出特立帕肽治疗老年性骨质疏松症的真实疗效和作用[5].本研究系统评估特立帕肽对老年性骨质疏松症患者BMD和骨标志物的影响以及生活质量的改变以及临床意义. ...
Effective osteoporosis treatment with teriparatide is associated with enhanced quality of life in postmenopausal women with osteoporosis: the European Forsteo Observational Study
1
2013
... 骨质疏松症是一种退化性疾病,已成为人类的重要健康问题, 患病风险随着年龄增长而增加.骨质疏松症是导致老年人脆性骨折的一个关键危险因素.骨质疏松症的患者存在骨痛、疲软、骨折以及生活质量下降等临床表现.骨质疏松的治疗方法可通过调节骨吸收和骨形成以达到减少或逆转骨重建的负平衡.甲状旁腺激素的生理学作用包括直接作用于成骨细胞刺激骨骼形成,间接增加肠道钙的吸收,增加肾小管钙的重吸收和增强磷酸盐在肾脏的排泄.特立帕肽是重组人内源性甲状旁腺激素的活性片段(1-34),是第一个用于临床的有促进骨形成的治疗骨质疏松症的药物,可更早增加骨形成,其幅度大于骨吸收,对骨重建平衡有积极的作用,它可以增加骨密度,改善骨微结构和强度,并减少骨折的发生[1-3].目前国内外对特立帕肽治疗骨质疏松症,主要用于有骨折高发风险的绝经后妇女骨质疏松症的治疗,主要研究集中于对骨密度(bone mineral density,BMD)的增加和骨折的减少[4].老年性骨质疏松症是原发性骨质疏松的Ⅱ型,目前特立帕肽治疗老年性骨质疏松症的文献不多,研究的时间也较短,不能反映出特立帕肽治疗老年性骨质疏松症的真实疗效和作用[5].本研究系统评估特立帕肽对老年性骨质疏松症患者BMD和骨标志物的影响以及生活质量的改变以及临床意义. ...
特立帕肽治疗原发性骨质疏松症的短期疗效观察
2
2013
... 骨质疏松症是一种退化性疾病,已成为人类的重要健康问题, 患病风险随着年龄增长而增加.骨质疏松症是导致老年人脆性骨折的一个关键危险因素.骨质疏松症的患者存在骨痛、疲软、骨折以及生活质量下降等临床表现.骨质疏松的治疗方法可通过调节骨吸收和骨形成以达到减少或逆转骨重建的负平衡.甲状旁腺激素的生理学作用包括直接作用于成骨细胞刺激骨骼形成,间接增加肠道钙的吸收,增加肾小管钙的重吸收和增强磷酸盐在肾脏的排泄.特立帕肽是重组人内源性甲状旁腺激素的活性片段(1-34),是第一个用于临床的有促进骨形成的治疗骨质疏松症的药物,可更早增加骨形成,其幅度大于骨吸收,对骨重建平衡有积极的作用,它可以增加骨密度,改善骨微结构和强度,并减少骨折的发生[1-3].目前国内外对特立帕肽治疗骨质疏松症,主要用于有骨折高发风险的绝经后妇女骨质疏松症的治疗,主要研究集中于对骨密度(bone mineral density,BMD)的增加和骨折的减少[4].老年性骨质疏松症是原发性骨质疏松的Ⅱ型,目前特立帕肽治疗老年性骨质疏松症的文献不多,研究的时间也较短,不能反映出特立帕肽治疗老年性骨质疏松症的真实疗效和作用[5].本研究系统评估特立帕肽对老年性骨质疏松症患者BMD和骨标志物的影响以及生活质量的改变以及临床意义. ...
, 彭绍蓉
