阿仑磷酸钠治疗早期成年非创伤性股骨头坏死的临床观察

Clinical efficacy of alendronate treatment of early-stage adult nontraumatic avascular necrosis of femoral head

目的探讨阿仑磷酸钠治疗早期成年非创伤性股骨头坏死的临床效果。方法选择非创伤性股骨头坏死患者83例，给予阿仑磷酸钠70mg口服，采用髋关节Harris评分标准进行治疗前和治疗后的评价。结果ARCOI型患者治疗前后比较，疼痛评分分别为（38．48±5．55）分对（41．45±3．55）分（t=3．70），功能评分分别为（43．97±2．31）分对（45．06±1．50）分（t=3．76），差异均有统计学意义（均P=0．001）；ARCO II型患者治疗前后疼痛[（37．32±6．65）分对（40．40±4．31）分，t=4．06，P=0．003、功能[（41．66±3．35）对（42．90±2．70），t=3．15，P=0．003]及活动度[（4．42±0．70）分对（4．76±0．47）分，t=3．35，P=0．002]评分比较，治疗后均明显优于治疗前，差异有统计学意义。结论阿仑膦酸钠能有效治疗早期非创伤性股骨头坏死，特别是ARCO II型，但对其远期效果有待进一步研究。

Objective To evaluate the influence of the alendronate treatment in early-stage adult nontraumatic avascular necrosis of femoral head. Methods The 83 patients with nontraumatic avascular necrosis of femoral head were enrolled in this study. They were given oral alendronate 70 mg weekly, and evaluated with Harris criteria before and after treatment. Results In the patients with ARCO I necrosis, the scores of pain and function were higher after treatment than before [（41.45±3.55） scores vs. （38.48±5.55） scores, t=3.70, P=0.001; （45.06±1.50） scores vs. （43.97± 2.31） scores, t=3.76, P=0.001]. In the patients with ARCO H necrosis, the scores of pain, function and activity were also higher after treatment than before [（40.40±4.31） scores vs. （37.32± 6.65） scores, t=4.06, P=0.00; （42.90±2.70） scores vs. （41.66±3.35） scores, t=3.15, P= 0.003; （4.76±0.47） scores vs. （4.42±0.70） scores, t=3.35, P=0.002]. Conclusions Alendronate is effective in treatment of early-stage adult nontraumatic avascular necrosis of femoral head, in particular for ARCO II patients. But its long-term effect is worth researching in future.