唑来磷酸联合密钙息治疗肺癌骨转移伴骨质疏松的临床研究

Clinical research of zoledronic acid with miacalcic in treatment of bone metastases with osteoporosis in patients with lung cancer

目的肺癌骨转移伴骨质疏松患者病情复杂，生活质量较差，涉及多学科综合诊疗。探讨唑来磷酸联合密钙息治疗肺癌骨转移伴骨质疏松的疗效和不良反应。方法选取2009年1月-2013年1月200例肺癌骨转移伴骨质疏松患者按随机数字表均分为2组，每组各100例。对照组予常规放化疗抗癌治疗，研究组在常规治疗的基础上使用4mg唑来磷酸注射液1次／月，联合50～100IU密钙息治疗。治疗3个月后，观察2组骨密度、骨代谢指标、疼痛、体力状况、骨转移病灶及不良反应等。结果研究组骨密度（t=-0．468，P=0．00）、骨代谢指标（NTx：t=3．127，P=0．03；BSP：t=4．961，P=0．02；Ca：t=-1．316，P=0．00；BGP：t=3．273，P=0．03；CTX：t=-0．351，P=0．01）、疼痛（H：3．391，P=0．02）、体力状况（u=3．621，P=0．04）、骨转移病灶（u=2．832，P=0．00）等情况改善均优于对照组，差异有统计学意义（P〈0．05）。骨骼相关事件（X^2=4．275，P=0．01）及不良反应发生率（X^2=3．782，P=0．02）低于对照组，差异有统计学意义（P〈0．05）。结论唑来磷酸联合密钙息治疗肺癌骨转移伴骨质疏松有较好的临床疗效，能有效缓解疼痛，改善骨质疏松临床症状，提高日常生活质量，降低骨转移病灶发生率，骨骼相关事件及不良反应发生率较低。

Objective To explore the curative effect and side effect of Zoledronie Acid with Miacalcic in treatment of bone metastases with osteoporosis in patients with lung cancer. Methods Total 200 cases of bone metastases with osteoporosis in lung cancer patients from 2009.1 to 2013.1 were randomly divided into two groups with 100 cases in each group. The control group was given the conventional radiation and chemotherapy treatment, while the research group received 4 mg Zoledronic Acid 1 times/month with 50 - 100 IU Miacalcic on the base of conventional radiation and chemotherapy treat- ment. After 3 months of treatment, the bone mineral density （ BMD ） and bone metabolic markers, metastatic bone pain, physical con.dition,lesion of bone metastases and adverse reactions were observed. Results The situation of the BMD （ t = - 0.468, P = 0.00）, bone metabolism markers （ NTx ： t = 3.127, P = 0.03 ; BSP ： t = 4.961, P = 0.02 ; Ca ： t = - 1.316, P = 0.00 ; BGP ： t =- 3. 273, P = 0.03 ; CTX ： t = - 0.351, P = 0.01 ）, metastatic bone pain （ u = 3.391, P = 0. 02 ）, physical condition （ u = 3.621, P = 0. 04）, lesion of bone metastases （ u = 2. 832, P = 0. 00） in the research group were superior to those in the control group,the difference was statistically significant（P 〈 0.05）. The skeletal related events（ X^2 = 4. 275, P = 0.01 ） and the incidence of adverse reaction（X^2 = 3. 782 ,P = 0.02） in the research group were lower than those in the control group, the difference were statistically significant（P 〈 0.05 ）. Conclusion Zoledronic acid with Miacalcic on metastases with osteoporosis in patients with lung cancer has a better clinical curative effect. The therapy can effectively relieve pain, improve the quality of daily life, reduce the incidence of bone metastases lesions, skeletal related events, and reduce the incidence of adverse reactions.