阿仑膦酸钠治疗老年女性骨质疏松性椎体压缩骨折的疗效分析

Effect of Alendronate Sodiumon Osteoporotic Vertebral Compression Fractures in Elderly Women

探讨老年女性骨质疏松性椎体压缩骨折经皮球囊扩张椎体后凸成形术(Percutaneous kyphoplasty,PKP)后,联合服用阿仑膦酸钠治疗的效果。文章选取2018年1月至2021年1月于该院骨外科行PKP手术治疗的绝经后骨质疏松性椎体压缩骨折患者102例,随机将其分为实验组(n=51)和对照组(n=51)。其中实验组,在PKP术后予以阿法骨化醇、碳酸钙D3片联合阿仑膦酸钠进行抗骨质疏松治疗,对照组予以阿法骨化醇、碳酸钙D3片治疗,口服药物6个月后,记录两组治疗前后骨密度、骨代谢标志物、背痛的(Visual analogue scale,VAS)评分和背部功能(The oswestry disability index,ODI)评分。通过6个月的药物治疗,实验组较使用药物之前,其骨密度有明显改善,实验组的髋关节、股骨头、腰1~4椎体的骨密度和T值均高于对照组(P<0.05)。在骨代谢方面,实验组的OC、Ⅰ型原胶原N-端前肽(Procollagen type 1 N-propeptide,P1NP)、I型胶原交联C-末端肽(Type I collagen carboxy-terminal peptide,CTX)均有明显下降,而25-(OH)-D_(3)则明显上升(P<0.05),表明阿仑膦酸钠通过降低骨转化率,可有效对抗该类患者术后的骨质疏松。同时,实验组腰背部的功能ODI评分和VAS疼痛评分也明显好于对照组(P<0.05)。老年女性骨质疏松性椎体压缩骨折PKP术后,联合阿仑膦酸钠进行抗骨质疏松治疗,可以提高骨密度,改善骨代谢,有利于提高患者的生活质量,减轻患者腰背部疼痛,改善患者腰背部功能。

To investigate the effect of combined therapy with alendronate sodium after percutaneous kyphoplasty(PKP)for osteopo-rotic vertebral compression fractures in elderly women,from January 2018 to January 2021,102 post-menopausal patients with osteo-porotic vertebral compression fractures who underwent PKP surgery in the authors′hospital were selected and randomly divided into the research group(n=51)and the control group(n=51).The research group were treated with alfa-calciferol,calcium carbonate D3 and alendronate sodium for anti-osteoporosis after PKP,and the control group was treated with alfa-calciferol and calcium carbo-nate D3.After 6 months,bone mineral density,bone metabolic markers,visual analogue scale(VAS)score and the oswestry disability index(ODI)score were recorded.After 6 months of drug treatment,the bone mineral density(BMD)of the research group was sig-nificantly improved compared with that before the drug was used.The BMD and T-score of the hip joint,femoral head and L1~4 in the research group were higher than those in the control group,with a statistically significant difference(P<0.05).In terms of bone metabolism,OC,procollagen type 1 N-propeptide(P1NP)and type I collagen carboxy-terminal peptide(CTX)in the research group were significantly decreased,while 25-(OH)-D_(3) was significantly increased(P<0.05),indicating that alendronate sodium could effectively fight against osteoporosis by reducing bone transformation rate.At the same time,the ODI score and VAS pain score of the research group were also significantly better than those of the control group(P<0.05).After PKP operation for osteoporotic vertebral compression fracture in elderly women,combined with alendronate sodium for anti-osteoporosis treatment can improve bone density and reduce bone transformation rate,improve the quality of life of patients,relieve their back pain,and promote the recovery of their back function.