请选择 进入手机版 | 继续访问电脑版
设为首页收藏本站

老西部英语

 找回密码
 立即注册

只需一步,快速开始

[大学生论坛]:通过唑来膦酸预防骨质减少症老年女性患者发生骨折

18

主题

18

资源

79

积分

注册会员

Rank: 2

积分
79
蓝色的大海 发表于 2019-1-3 21:42:32 | 显示全部楼层 |阅读模式
Fracture Prevention with Zoledronate in Older Women with Osteopenia
通过唑来膦酸预防骨质减少症老年女性患者发生骨折


本文来自:https://www.nejm.org/doi/full/10 ... atedRelated_article


Abstract
摘要

Background
Bisphosphonates prevent fractures in patients with osteoporosis, but their efficacy in women with osteopenia is unknown. Most fractures in postmenopausal women occur in those with osteopenia, so therapies that are effective in women with osteopenia are needed.
背景
二磷酸盐可预防骨质疏松症患者发生骨折,但对于骨质减少症女性患者来说,其功效尚不清楚。绝经后的妇女发生骨折,大多数情况都是患有骨质减少症,因此骨质减少症女性患者需要有效的治疗方法来进行治疗。

Methods
We conducted a 6-year, double-blind trial involving 2000 women with osteopenia (defined by a T score of −1.0 to −2.5 at either the total hip or the femoral neck on either side) who were 65 years of age or older. Participants were randomly assigned to receive four infusions of either zoledronate at a dose of 5 mg (zoledronate group) or normal saline (placebo group) at 18-month intervals. A dietary calcium intake of 1 g per day was advised, but calcium supplements were not provided. Participants who were not already taking vitamin D supplements received cholecalciferol before the trial began (a single dose of 2.5 mg) and during the trial (1.25 mg per month). The primary end point was the time to first occurrence of a nonvertebral or vertebral fragility fracture.
研究方法
我们进行了一项为期6年的双盲试验,该测试涉及2000名患有骨质减少症的女性(全髋部或股骨颈的T分数在-1.0至-2.5之间),年龄在65岁及以上。我们将调查对象进行随机分组,让她们接受4次输注,注入液分别为5mg剂量的唑来膦酸(唑来膦酸盐组)和生理盐水(安慰剂组),每次输注间隔均为18个月。我们还建议她们每天摄入1克钙,但不为她们提供钙补充剂。调查对象如果尚未服用维生素D补充剂,则在测试开始前要摄入单剂量为2.5mg的胆钙化醇,测试期间每个月要摄入1.25mg的胆钙化醇。测试主要指标是非椎骨或椎骨首次发生脆性骨折的时间。

Results
At baseline, the mean (±SD) age was 71±5 years, the T score at the femoral neck was −1.6±0.5, and the median 10-year risk of hip fracture was 2.3%. A fragility fracture occurred in 190 women in the placebo group and in 122 women in the zoledronate group (hazard ratio with zoledronate, 0.63; 95% confidence interval, 0.50 to 0.79; P<0.001). The number of women that would need to be treated to prevent the occurrence of a fracture in 1 woman was 15. As compared with the placebo group, women who received zoledronate had a lower risk of nonvertebral fragility fractures (hazard ratio, 0.66; P=0.001), symptomatic fractures (hazard ratio, 0.73; P=0.003), vertebral fractures (odds ratio, 0.45; P=0.002), and height loss (P<0.001).
研究结果
在基线状态下,患者平均年龄为71岁(标准差为5),平均股骨颈T分数为-1.6(标准差为0.5),10年内患髋部骨折的风险中间值为2.3%。安慰剂组有190名女性发生了脆性骨折,唑来膦酸盐组有122名(唑来膦酸组风险比为0.63; 95%置信区间0.50 ~ 0.79; P <0.001)。每1名女性发生骨折,就有15名女性需要接受治疗以预防骨折的发生。相较于安慰剂组,摄入唑来膦酸的女性患骨折的风险更低,包括非椎骨脆性骨折(风险比0.66; P = 0.001)、症状性骨折(风险比0.73; P = 0.003)、椎骨骨折(优势比0.45; P = 0.002),另外身高缩减的风险也更低(P <0.001)。

Conclusions
The risk of nonvertebral or vertebral fragility fractures was significantly lower in women with osteopenia who received zoledronate than in women who received placebo. (Funded by the Health Research Council of New Zealand; Australian New Zealand Clinical Trials Registry number, ACTRN12609000593235.)
结论
摄入唑来膦酸的骨质减少症女性患者患非椎骨或椎骨脆性骨折的风险明显低于服用安慰剂的患者。



作者:Ian R. Reid, M.D., Anne M. Horne, M.B., Ch.B., Borislav Mihov, B.Phty., Angela Stewart, R.N., Elizabeth Garratt, B.Nurs., Sumwai Wong, B.Sc., Katy R. Wiessing, B.Sc., Mark J. Bolland, Ph.D., Sonja Bastin, M.B., Ch.B., and Gregory D. Gamble, M.Sc.
期刊名称:The New England Journal of Medicine
发表时间:2018-12-20
N Engl J Med 2018;  379:2407-2416 | DOI:  10.1056/NEJMoa1808082

友荐云推荐
评论

使用道具 举报


QQ|关于我们|联系我们|网络条款|建议反馈|小黑屋|老西部英语 ( 版权所有 粤ICP备11103350号  

GMT+8, 2019-3-25 00:04 , Processed in 0.198321 second(s), 34 queries .

Powered by Discuz! X3

© 2001-2013 Comsenz Inc.