帕米磷酸二钠治疗恶性肿瘤骨转移高钙血症的临床疗效分析

The clinical effect of pamidronate disodium on hypercalcemia due to malignant bone metastasis

目的探讨帕米磷酸二钠注射液治疗恶性肿瘤骨转移所致高钙血症的临床疗效及安全性。方法选择52例诊断为恶性肿瘤骨转移所致高钙血症的患者为研究对象,随机分为研究组和对照组,每组各26例。研究组患者采用帕米磷酸二钠治疗,对照组患者采用唑来磷酸治疗。两组均每月治疗1次,共治疗6个月。比较两组患者的血钙(Ca)、血磷(P)、甲状腺旁素(PTH)、碱性磷酸酶(AKP)、骨钙素(BGP)以及骨密度(BMD)的差异,随访6个月比较两组的临床疗效、止痛效果、转移灶改善、KPS评分及不良反应发生率的差异。结果与对照组相比,研究组患者的Ca、PTH、AKP、BGP和BMD均显著降低,而研究组的血P则显著升高(P<0.05);研究组的总有效率较高,各种不良反应发生率较高(P<0.05),而止痛效果、转移灶改善、KPS评分与对照组相比差异无统计学意义(P>0.05)。结论帕米磷酸二钠治疗恶性肿瘤骨转移所致高钙血症的临床疗效显著,但不良反应较多。

Objective To evaluate the clinical efficacy and safety of pamidronate disodium on hy- perealcemia due to malignant bone metastasis. Methods A total of 52 patients with hypercalcemia and ma- lignant bone metastasis were randomizedly divided into two groups, research group （26 patients, received pamidronate disodium） and control group （26 patients, received zoledronic acid）. The course of treatment was 6 months. The indexes of serum calcium, serum phosphate, parathormone （PTH） , alkaline phospha- tase （AKP）, bone gla protein （BGP） and bone mineral density （BMD） were compared between two groups. After 6 months follow-up, the clinical efficacy, relieving pain, KPS score, metastatic focus and ad- verse reactions were also compared between two groups. Results Compared to control group, the indexes of serum calcium, PTH, AKP, BGP and BMD in research group were lower （ P 〈 0. 05 ） , and the serum phosphate were higher in research group （ P 〈 O. 05 ）. The total effective rate in research group was higher and the incidence of adverse reactions were higher than control group （ P 〈 0. 05 ） , but the relieving pain, the change of metastatic focus, KPS score were same between two groups （ P 〉 0. 05 ）. Conclusions The clinical efficacy of pamidronate disodium on hypercalcemia due to malignant bone metastasis was perfect, but adverse reaction rate was high.