摘要目的 对老年骨质疏松患者进行药物及健康教育的干预,评价骨密度、血清骨转化因子、血清细胞因子等的变化. 方法 回顾性分析,将220例老年骨质疏松患者随机分为观察组和对照组(各110例).对照组给予常规指导,每天补充钙剂+活性维生素D;观察组在药物治疗的基础上给予生活方式、饮食、运动等健康教育的干预.1年后比较两组骨密度、总Ⅰ型胶原氨基端延长肽(T-PINP)、β胶原特殊序列(β-CTx)、甲状旁腺素(PTH)及25羟基维生素D(25(OH)VD)、白细胞介素2(IL-2)、胰岛素样生长因子Ⅰ(IGF-1R)的变化. 结果 随访1年,除β-CTx观察组其他各项指标与对照组比均有改善(P＜0.05).观察组的骨密度变化率高于对照组,第二腰椎:12.1％比8.9％(P＜0.05)、第四腰椎:24.9％比12.4％ (P＜0.01).随访1年期间,对照组发生跌倒10例,干预组3例(P＜0.05).观察组的疼痛改善率10.9％(12/110)高于对照组5.5％(6/110)(P＜0.05).观察组的骨质疏松认知水平和生活方式的改善均高于对照组(P＜0.05). 结论 健康教育干预对骨质疏松的防治有益,可改善老年患者的骨质疏松认知度和生活方式,对于骨质疏松的综合诊治起着重要作用.

abstractsObjective To examine changes in bone mineral density,serum bone turnover markers and serum cytokines after health education intervention in elderly patients with osteoporosis.Methods Two hundred and twenty elderly patients with osteoporosis were randomly divided into two groups.The control group(n=110)was given routine treatment,including anti-osteoporosis drugs and daily supplements of calcium and vitamin D.In addition to routine drug treatment,the observation group(n=110)also underwent health education intervention,which included instructions on lifestyle,diet,and exercise.After one year follow up,levels of bone mineral density(BMD),propeptide of type Ⅰ procollagen(PINP),β crosslaps (β-CTX),parathyroid hormone (PTH),25-dihydroxyvitamin D [25(OH) VD],interleukin-2 (IL-2),and insulin-like growth factor-1 receptor (IGF-1 R) were analyzed.Results After one year follow-up,all indicators,except the β-CTX level,were significantly improved in the observation group compared with those in the control group(all P＜0.05).Mean while,compared with pre-treatment levels,both groups had significantly increased levels of BMD(both P＜ 0.05),which were markedly higher in the observation group (P ＜ 0.05).Furthermore,improvement was achieved in cognitive ability and lifestyle in the observation group (both P ＜ 0.05).Conclusions Health education intervention can effectively improve BMD in elderly patients with osteoporosis,significantly improve lifestyle,and play an important role in integrated management of osteoporosis.