目的 觀察地舒單抗注射液聯(lián)合特立帕肽注射液治療絕經(jīng)后骨質(zhì)疏松癥的臨床療效。方法 選擇2022年1～12月南通市腫瘤醫(yī)院收治的絕經(jīng)后骨質(zhì)疏松癥患者91例，按照隨機(jī)數(shù)字表法將所有患者分為對照組（45例）和治療組（46例）。對照組在大腿或腹部皮下注射特立帕肽注射液20 μg，1次/d，持續(xù)治療6個月。治療組在對照組的基礎(chǔ)上在大腿、腹部或上臂部單次皮下注射地舒單抗注射液60 mg，6個月僅注射1次。比較兩組的臨床療效、骨密度、骨代謝指標(biāo)。結(jié)果 治療后，治療組的總有效率為89.13%，高于對照組的總有效率75.56%（P＜0.05）。治療后，兩組腰椎L_1-4、股骨頸、全髖骨密度均顯著升高（P＜0.05），且治療組腰椎L_1-4、股骨頸、全髖骨密度均高于對照組（P＜0.05）。治療后，兩組血清β-膠原特殊序列（β-CTX）、抗酒石酸酸性磷酸酶-5b（TRAP-5b）、Ⅰ型膠原羧基末端肽（CTX-Ⅰ）水平顯著下降，血清總I型膠原氨基端延長肽（TP1NP）、骨鈣素（OCN）、骨保護(hù)素（OPG）水平顯著升高（P＜0.05），且治療組血清β-CTX、TRAP-5b、CTX-Ⅰ水平低于對照組，血清TP1NP、OCN、OPG水平高于對照組（P＜0.05）。結(jié)論 地舒單抗聯(lián)合特立帕肽注射液治療絕經(jīng)后骨質(zhì)疏松癥可提高臨床療效，改善骨密度，調(diào)節(jié)骨代謝。

Objective To observe the clinical efficacy of Denosumab Injection combine with Teriparatide Injection in treatment of postmenopausal osteoporosis. Methods Women (91 cases) with postmenopausal osteoporosis in Nantong Tumor Hospital from January to December 2022 were divided into the control group (45 cases) and the treatment group (46 cases) according to the random number table method. Women in the control group were sc injected with Teriparatide Injection in the thighs or abdomen for 20 μg, once daily, continuous treatment for 6 months. Women in the treatment group were a single sc injection with Denosumab Injection in the thighs, abdomen, or upper arms, on the basis of the control group, only one injection in 6 months. The clinical efficacies, the bone mineral density, and bone metabolism index in two groups were compared. Results After treatment, the total effective rate of the treatment group was 89.13%, which was higher than 75.56% of the control group (P < 0.05). After treatment, the bone density of lumbar L_1-4, femoral neck, and hip in two groups was significantly increased (P < 0.05), and the bone density of lumbar L_1-4, femoral neck, and hip in treatment group was higher than that in control group (P < 0.05). After treatment, the serum levels of β-CTX, TRAP-5b, and CTX-Ⅰ in two groups were significantly decreased, while the serum levels of TP1NP, OCN, and OPG in two groups were significantly increased (P < 0.05). The serum levels of β-CTX, TRAP-5b, and CTX-Ⅰ in the treatment group were lower than those in the control group, but the serum levels of TP1NP, OCN, and OPG in the treatment group were higher than those of control group (P < 0.05). Conclusion Denosumab Injection combine with Teriparatide Injection can improve clinical efficacy, improve bone mineral density, and regulate bone metabolism in treatment of postmenopausal osteoporosis.

R977

江蘇省衛(wèi)生健康委醫(yī)學(xué)科研立項(xiàng)項(xiàng)目（ZDXKA2021185）