当科における骨粗鬆症治療の検討―主訴，年齢，初診時骨塩量と治療効果との関係について

Clinical Analysis of the Treatment of Osteoporosis : Associations between Clinical Results and Chief Complaint, Age, and Initial Bone Mineral Density

　抄録：われわれは，主訴，年齢，初診時骨塩量が骨粗鬆症治療効果を予測できる因子となり得るかどうかを検討した．対象は当科で骨粗鬆症治療を受けた女性106例，平均年齢は68.6歳であった．治療はEHDPの間欠投与とし，24カ月後の骨塩量増加率を評価の指標とした．主訴に関しては疼痛群，検診，希望群において骨折群に比べ骨塩量増加率が有意に高かった．年齢と骨塩増加率との間に正の相関，また初診時骨塩量と骨塩量増加率との間に負の相関を認めた．主訴，年齢，初診時骨塩量は治療効果を予測する因子となりえると考えられた．

　Previous studies have shown that etidronate can increase bone mineral density (BMD) in postmenopausal osteoporosis, but the improvement differs from individual to individual. It would be a great advantage if it were possible to estimate how much BMD could be improved before starting therapy. In this study we attempted to determine whether chief complaint, age and initial BMD are predictors of improvement in BMD. The subjects were 106 postmenopausal women aged 55 to 88 years who had osteoporosis and had been treated with intermittent cyclical etidronate therapy since 1998 (mean follow up time：26-months). Improvement was assessed on the basis of BMD measurements made by a digital image processing method before treatment and at 24months. Concerning chief complaint, the subjects were divided in to three groups according to their chief complaint. The BMD of the group in which the initial complaint was “pain” and “applicant for osteoporosis therapy” statistically significantly improved compared with the BMD of the group in which the intial complaints was “fracture”. Age and initial BMD were strongly associated with improvement in BMD. The data also suggested that a favorable response could be expected if the initial BMD value was below 2.20mmAl. We concluded that chief complaint, age, and initial BMD are predictors of improvement in BMD in response to etidronate therapy of postmenopausal osteoporosis.