目的 探讨地舒单抗联合雷洛昔芬对绝经后骨质疏松患者性激素结合蛋白(SHBG)、骨硬化蛋白(SOST)水平的影响。方法 选取解放军总医院第三医学中心2022-05至2023-05收治的绝经后骨质疏松患者共140例,随机分为对照组(n=70)和研究组(n=70)。对照组采用雷洛昔芬治疗,60 mg/次,1次/d口服;研究组采用雷洛昔芬联合地舒单抗治疗,两组治疗时间均为1年。收集两组治疗前后的相关指标,并对两组患者治疗前临床效果进行对比分析。结果 治疗1年后,研究组治疗有效率为94.29%,明显高于对照组(82.86%),两组比较差异有统计学意义(P＜0.05)。与治疗前比较,两组治疗后雌二醇(E2)、促卵泡激素(FSH)、促黄体生成素(LH)、骨密度、骨矿含量、超氧化物歧化酶(SOD)、谷胱甘肽(GSH)表达水平均升高,且研究组明显高于对照组,差异均有统计学意义(P＜0.05)。丙二醛(MDA)、SHBG、SOST、Ⅰ型胶原交联氨基端肽(NTX1)、Ⅰ型胶原交联羧基端肽(CTX1)、抗酒石酸酸性磷酸酶5b(TRACP5b)、骨钙素(BGP)表达水平降低,且研究组明显低于对照组,差异均有统计学意义(P＜0.05)。结论 绝经后骨质疏松患者采用地舒单抗联合雷洛昔芬治疗效果显著,不但可改善骨代谢水平及氧化应激反应,且可降低SHBG、SOST表达。
Abstract
Objective To investigate the effects of desucumab combined with raloxifene on the levels of sex hormone binding protein (SHBG) and osteosclerosis protein (SOST) in postmenopausal osteoporosis patients. Methods A total of 140 postmenopausal osteoporosis patients admitted to the Third Medical Center of PLA General Hospital from May 2022 to May 2023 were selected and randomly divided into a control group and a study group, with 70 cases in each group. The control group was treated with raloxifene for 1 year, 60 mg/time, once/day orally, while the study group received treatment of a combination of raloxifene and desucumab for 1 year. The relevant indicators before and after treatment were collected, and the clinical effects of the two groups were compared and analyzed. Results After 1 year of treatment, the effective rate of the study group was significantly higher than that in the control group(94.29% vs. 82.86%), and the difference between the two groups was statistically significant (P<0.05).Compared with before treatment, the expression levels of estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), bone density, bone mineral content, superoxide dismutase (SOD), and glutathione (GSH) in the two groups increased after treatment, and the study group was significantly higher than the control group, with statistical significance (P<0.05). The expression levels of malondialdehyde (MDA), SHBG, SOST, type I collagen cross-linked amino terminal peptide (NTX1), type I collagen cross-linked carboxyl terminal peptide (CTX1), tartaric acid phosphatase 5b (TRACP5b), and osteocalcin (BGP) were reduced, and the study group was significantly lower than the control group, with statistical significance (P<0.05). Conclusions The combined use of desucumab and raloxifene can improve bone metabolism and oxidative stress, reduce the expression of SHBG and SOST in postmenopausal osteoporosis patients.
关键词
绝经后 /
骨质疏松 /
地舒单抗 /
雷洛昔芬 /
性激素结合蛋白 /
骨硬化蛋白
Key words
postmenopausal /
osteoporosis /
desucumab /
raloxifene /
sex hormone binding protein /
osteosclerosis protein
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