方针,何帮剑,杜深星.早期减重支持训练对脑卒中后骨质疏松症患者骨保护素和核因子-κB受体活化因子配体的影响[J].中华物理医学与康复杂志,2020,42(2):152-155
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| 早期减重支持训练对脑卒中后骨质疏松症患者骨保护素和核因子-κB受体活化因子配体的影响 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2020.02.015 |
| 中文关键词: 减重支持训练 脑卒中 骨质疏松症 骨保护素 核因子-κB受体活化因子配体 |
| 英文关键词: Treadmill training Stroke Osteoporosis |
| 基金项目:浙江省医药卫生科技计划一般研究项目（2011KYA117）；全国名老中医药专家传承工作室建设项目（国中医药人教发［2014］20号）；国家中医药管理局“十二五”中医药重点学科（国中医药人教发［2012］32号） |
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| 中文摘要: |
| 目的 观察早期减重支持训练对卒中后骨质疏松症患者骨保护素（OPG）和核因子-κB受体活化因子配体（RANKL）的影响。 方法 将脑卒中后骨质疏松症患者60例随机分成治疗组和对照组，每组患者30例，对照组采用药物（密钙息、阿法骨化醇、福善美）联合常规康复训练进行治疗，治疗组在药物治疗方案的基础上增加早期减重支持训练。于治疗前、治疗3个月后、治疗6个月后和出院1年后（随访时）检测2组患者的腰椎BMD和骨转化调节指标（包括OPG、RANKL、RANKL/OPG）。 结果 2组患者骨密度（BMD）、OPG、RANKL、RANKL/OPG在治疗后均有一定程度的改善，对照组在治疗6个月后，其OPG和RANKL分别为（11.9±9.7）pmol/L和（290.7±87.0 ）pmol/L，与组内治疗前比较，差异均有统计学意义（P<0.05），对照组患者的OPG、RANKL和RANKL/OPG与组内治疗前比较，差异均有统计学意义（P<0.05）。治疗3、6个月后和出院1年后，治疗组患者的BMD、OPG、RANKL、RANKL/OPG均显著改善，且均显著优于组内治疗前和对照组相同时间点，差异均有统计学意义（P<0.05）。 结论 早期应用减重支持训练可显著下调脑卒中后骨质疏松症患者OPG、RANKL的表达，提高RANKL/OPG比率，改善BMD及其骨质疏松状态。 |
| 英文摘要: |
| Objective To observe any effect of early-stage body weight-supported treadmill training on the progression of osteoporosis after a stroke. Methods Sixty stroke survivors with osteoporosis were randomly divided into a treatment group and a control group, each of 30. Both groups were given routine medication including Miacalcic, α-D3 and Fosamax, along with standard rehabilitation training. The treatment group was additionally subjected to body weight-supported treadmill training. The bone mineral density (BMD), serum osteoprotegerin (OPG) and serum NF-κ B ligand receptor activator (RAKNL) levels were measured for both groups before and after 3, 6 and 12 months of treatment. Results The average BMD, OPG and RAKNL levels and the RANKL/OPG ratio in both groups improved with treatment. After 3, 6 and 12 months of treatment, all four average indicators were superior to those of the control group at the same time points. Conclusion Body weight-supported treadmill training can significantly retard the development of osteoporosis. |
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