唑来膦酸联合阿法骨化醇治疗骨质疏松症的效果及其对骨转换、骨代谢功能的影响

Effect of zoledronic acid combined with opialaciol in the treatment of osteoporosis and its effect on bone turnover and bone metabolism

目的研究唑来膦酸联合阿法骨化醇治疗骨质疏松症的效果及其对骨转换、骨代谢功能的影响。方法选择2015年1月—2017年12月在濮阳市中原油田濮东医院进行诊治的95例骨质疏松症患者,随机分为两组。对照组口服阿法骨化醇治疗,0.5μg/次,1次/d。观察组联合静脉滴注唑来膦酸,5 mL唑来膦酸溶于100 mL生理盐水中以恒定的速度进行静脉滴注。两组均治疗12个月。比较两组的临床治疗效果,检测两组骨转换指标、骨代谢指标,并统计两组不良反应情况。结果观察组的有效率为91.48%,显著高于对照组的72.92%(P<0.05)。两组治疗后的Ⅰ型胶原交联C-末端肽(CTX-1)均显著降低(P<0.05),骨钙素(OC)显著升高(P<0.05),且观察组较对照组变化更为显著(P<0.05)。两组治疗后的血清碱性磷酸酶、甲状旁腺素以及骨特异碱性磷酸酶等骨代谢指标均显著降低(P<0.05),且观察组较对照组降低地更为显著(P<0.05)。观察组的不良反应发生率为6.38%,与对照组的4.17%相比无明显差异(P<0.05)。结论唑来膦酸联合阿法骨化醇治疗骨质疏松症的效果明显优于单独使用阿法骨化醇,可以有效改善患者的骨转换和骨代谢状态,具有较高的临床参考价值。

Objective To investigate the clinical effect of zoledronic acid combined with opialaciol in the treatment of osteoporosis and its effect on bone turnover and bone metabolism.Methods Selected 95 cases of patients with opialaciol who were treated in our hospital from January 2015 to December 2016, divided into two groups randomly. The control group was treated with opialaciol, and the observation group combined zoledronic acid with intravenous drip. The clinical therapeutic effects of the two groups were compared.Results After treatment, the effective rate of the observation group was 91.48% (43/47), significantly higher than that of the control group 72.92%(35/48) (P<0.05). The CTX-1 after treatment in the two groups was significantly decreased (P<0.05), and the OC was significantly increased (P<0.05), and the observation group was more obvious (P<0.05). The serum alkaline phosphatase, parathyroid hormone and bone specific alkaline phosphatase were significantly decreased (P<0.05), and the observation group decreased more significantly (P<0.05). The incidence of adverse reactions in the observation group was 6.38% (3/47), and there was no significant difference compared with 4.17% (2/48) of the control group.Conclusion The effect of zoledronic acid combined with opialaciol on osteoporosis is significantly better than that of opialaciol alone, which can effectively improve bone turnover and bone metabolism status of patients, and has high clinical reference value.