地舒单抗联合唑来膦酸钠治疗老年骨质疏松症患者的效果及对骨密度、骨代谢指标及炎症因子的影响

Curative Effect of Denosumab Combined with Zoledronate Sodium on Elderly Osteoporosis and Its Influences on Bone Mineral Density,Bone Metabolism Indexes and Inflammatory Factors

目的:探讨地舒单抗联合唑来膦酸钠对老年骨质疏松患者骨密度、骨代谢指标以及炎性因子的影响.方法:选取2020年7月至2021年10月在本院确诊的120例老年骨质疏松患者,采用随机数字表分组法将患者分为A、B、C三组,每组各40例.A组患者采用单次静注唑来膦酸钠溶液治疗,B组患者采用单次皮下注射地舒单抗治疗,C组患者采用单次静注唑来膦酸钠溶液结合皮下注射地舒单抗治疗,均持续治疗6个月.比较三组患者治疗前、后视觉模拟评分(VAS)、骨密度、骨代谢指标以及炎性因子水平.结果:治疗后,C组VAS评分较A组、B组显著降低(P<0.05);骨密度较A组、B组显著升高(P<0.05);甲状旁腺素(PTH)、Ⅰ型羧基端交联端肽胶原(CTX)均较A组、B组显著降低(P<0.05);Ⅰ型前胶原氨基端前肽(PINP)较A组、B组显著升高(P<0.05);C组白细胞介素(IL)-1、IL-8、肿瘤坏死因子(TNF)-α均较A组、B组显著降低(P<0.05).而A组、B组之间各指标比较,差异均无统计学意义(P>0.05).结论:地舒单抗联合唑来膦酸钠治疗能够明显降低老年骨质疏松患者VAS评分、提高骨密度、改善骨代谢指标、降低炎性因子,提高老年患者骨量.

Objective:To explore the effects of denosumab combined with zoledronate sodium on bone mineral density,bone metabolism indexes and inflammatory factors in elderly patients with osteoporosis.Methods:A total of 120 elderly patients with osteoporosis diagnosed in our hospital were enrolled from July 2020 to October 2021.According to random number table method,they were divided into group A(n=40,intravenous injection of zoledronate sodium),group B(n=40,subcutaneous injection of denosumab)and group C(n=40,intravenous injection of zoledronate sodium combined with subcutaneous injection of denosumab).After 6 months of continuous treatment,visual analogue scale(VAS)scores,bone mineral density,bone metabolism indexes and inflammatory factors in the three groups were detected before and after treatment.Results:After treatment,compared with group A and group B,in group C,VAS score was significantly decreased(P<0.05),bone mineral density values were significantly increased(P<0.05),parathyroid hormone(PTH)and typeⅠcollage cross-linked-telopeptide(CTX)were significantly reduced(P<0.05),procollagen typeⅠN-terminal propeptide(PINP)was significantly increased(P<0.05),and levels of interleukin(IL)-1,IL-8 and tumor necrosis factor(TNF)-ɑwere significantly decreased(P<0.05).However,there was no significant difference in the above indexes between group A and group B(P>0.05).Conclusion:Densuzumab combined with zoledronate sodium can significantly reduce VAS score,increase bone mineral density,improve bone metabolism indexes,reduce inflammatory factors and improve bone mass in elderly patients with osteoporosis.