唑来膦酸与伊班膦酸治疗癌性骨痛临床观察

Clinical observation of zoledronic acid and ibandronate in treating tumorous osteodynia

目的评价注射用唑来膦酸与伊班膦酸治疗癌性骨痛的临床疗效和安全性。方法 52例患者随机分为唑来膦酸组和伊班膦酸组各26例,唑来膦酸组给予唑来膦酸治疗,伊斑膦酸组给予伊班膦酸治疗,2组均用药2～4个周期。观察2组用药后止痛效果、实验室检查、骨修复、活动能力及不良反应发生情况。结果用药第12天时唑来膦酸组临床获益率为92.3%高于伊班膦酸组的88.5%,差异有统计学意义(P<0.05);治疗56d唑来膦酸组临床获益率为96.2%,伊班膦酸组为92.3%,差异无统计学意义(P>0.05)。2组共发生血钙轻度升高7例,轻度低血磷14例,经处理均恢复正常。2组均未出现骨软化,且活动能力均得到明显改善。2组主要不良反应主要为发热、乏力,严重程度与骨质损害呈正相关。结论唑来膦酸止痛疗效略优于伊班膦酸,且唑来膦酸静脉滴注时间短(15min),使用更方便。两者不良反应均较轻,均有良好的耐受性,值得临床推广应用。

Objective To evaluate the clinical therapeutic effect and safeness of zoledronic acid and ibandronate in tumorous osteodynia.Methods 52 cases were randomly divided into zoledronic acid group and ibandronate group,26 cases of each.The zoledronic acid group was treated with zoledronic acid,while the ibandronate group was treated with ibandronate.Both groups were treated for 2 to 4 cylces.Observed 2 group′s odynolysis effect,laboratory examination and situations of bone reparation,activity ability and adverse reaction.Results On the twelfth day of administration,the clinical benefit rate of zoledronic acid group was 92.3% higher than 88.5% of the ibandronate group,and the difference was statistically significant（P〈0.05）.On the 56th day of administration,the clinical benefit rate of zoledronic acid group was 96.2% higher than 92.3% of the ibandronate group,and the difference was of no statistical significance（P〉0.05）.In 2 groups,7 cases occurred a light rise of serum calcium level,14 cases occurred a light drop of serum phosphonium,and all cases returned to normal after been dealed.Both groups didn′t occur osteomalacia,and the activity ability were significantly improved.The main adverse reactions of 2 groups were fever and weakness,and the severity had positive correlation with bone damage.Conclusion The odynolysis effect of zoledronic acid is a cute above biophosphonate in treating tumorous osteodynia,and it is more easy to use with a shorter time of iv（15min）.Both of the two drugs has slight adverse reaction and good tolerance.Which are worth clinical popularizing and application.