经皮椎体成形术联合阿仑膦酸钠对压缩性骨折患者的临床疗效及对骨代谢标志物和血清瘦素、脂联素水平的影响

Clinical efficacy of percutaneous vertebroplasty combined with alendronate in patients with compression fractures and its effect on bone metabolism markers and serum leptin and adiponectin levels

目的 探讨经皮椎体成形术(PVP)联合阿伦磷酸钠对压缩性骨折患者的临床疗效及对骨代谢标志物和血清瘦素、脂联素水平的影响。方法 选择信阳市第五人民医院82例压缩性骨折病人,按随机数字表法分成两组各41例,分别为对照组和联合组,所有患者均行PVP术,对照组在术后采用常规治疗,联合组在对照组的基础上再给予阿伦磷酸钠治疗。疗程均为1年,对比两组临床疗效、治疗前后骨代谢标志物及血清瘦素、脂联素水平。结果 联合组患者临床总有效率高于对照组(P<0.05);治疗后,两组患者抗酒石酸酸性膦酸酶-5b(TRACP-5b)、Ⅰ型胶原C端肽(CTX-Ⅰ)、骨碱性磷酸酶(BALP)水平低于治疗前(P<0.05),且联合组低于对照组(P<0.05),两组患者25羟基维生素D_(3)[25(OH)D_(3)]水平高于治疗前(P<0.05),且联合组高于对照组(P<0.05);治疗后,联合组患者血清瘦素、脂联素水平低于治疗前(P<0.05),且联合组低于对照组(P<0.05)。结论 PVP术联合阿伦磷酸钠治疗压缩性骨折患者的临床效果显著,可有效改善骨代谢,降低血清瘦素与脂联素水平。

Objective To investigate the clinical effect of percutaneous vertebroplasty(PVP)combined with alendronate on patients with compression fracture and its influence on bone metabolism markers and serum leptin and adiponectin levels.Methods Totally 82 patients with compression fracture were selected and divided into two groups according to the method of random number table:41 patients in the control group and 41 patients in the combination group.All pa⁃tients were treated with PVP.The control group was treated with routine treatment after operation,and the combination group was treated with alendronate on the basis of the control group.The course of treatment was 1 year,and the clinical efficacy,bone metabolism markers and serum leptin and adiponectin levels before and after treatment were compared be⁃tween the two groups.Results The total clinical effective rate of the combined group was higher than that of the control group(P<0.05);After treatment,the levels of tartrate-resistant phosphonate-5b(TRACP-5b),C-terminal peptide of type I collagen(CTX-I)and bone alkaline phosphatase(BALP)in the two groups were lower than those of before treatment(P<0.05),the combined group were lower than those of the control group(P<0.05),and the levels of 25-hydroxyvitamin D_(3)[25(OH)D_(3)]in the two groups were higher than those of before treatment(P<0.05),and the combined group was higher than that of the control group(P<0.05);After treatment,the serum leptin and adi⁃ponectin levels in the combined group were lower than those of before treatment(P<0.05),and the combined group was lower than those of the control group(P<0.05).Conclusion The clinical effect of PVP combined with alendr⁃onate in the treatment of compression fracture is significant,which can effectively improve bone metabolism and reduce serum leptin and adiponectin levels.