塞来昔布预防唑来磷酸治疗老年性骨质疏松症不良反应的疗效观察

The efficacy of celecoxib in preventing the adverse reaction of zoledronic acid in the treatment of senile osteoporosis

目的探讨预防应用塞来昔布是否可以减少使用唑来磷酸治疗老年性骨质疏松症不良反应的发生。方法选取2012年1月至2015年1月老年性骨质疏松症患者116例,年龄61~86岁。依据输注唑来磷酸前是否预防应用塞来昔布及布洛芬分为空白对照组、布洛芬组、塞来昔布组。观察输注唑来磷酸过程中及输液后3 d内不良反应发生的情况。结果 （1）塞来昔布组发热比例最少,塞来昔布组7例（14%）、布洛芬组8例（25%）、空白对照组13例（38.2%）。（2）中热（38.1-39℃）、高热（〉39℃）的塞来昔布组比例显著低于其他两组,而低热（37.3-38℃）的塞来昔布组比例略高于其他两组。各组在不同发热程度的比例分别为：塞来昔布组：低热4例（8%）、中热2例（4%）、高热1例（2%）;布洛芬组：低热3例（6.3%）、中热3例（9.4%）、高热3例（9.4%）;空白对照组：低热2例（5.9%）、中热5例（14.7%）、高热6例（17.6%）。三组发热程度比较有显著性差异（P〈0.05）。（3）肌肉痛、骨骼关节疼痛、流感样症状、消化道症状、头晕、头痛、心悸等不良反应发生率均为塞来昔布组最低。除心悸、皮疹外,其他不良反应发生率在三组间均有显著性差异（P〈0.05）。结论预防性应用塞来昔布可以减少唑来磷酸不良反应的发生。

Objective To investigate whether the use of celecoxib can reduce the occurrence of adverse reaction of zoledronic acid in the treatment of senile osteoporosis. Methods One hundred and sixteen senile patients with osteoporosis, aging from 61 to 86 years old, were selected from January 2012 to January 2015. According to whether the patients received celecoxib or Ibuprofen as preventive application before infusion of zoledronic acid, they were divided into blank control group, Ibuprofen group, and celecoxib group. The occurrence of adverse reaction was observed during the infusion of zoledronic acid in 3 days after the infusion. Results 1 ） The minimum proportion of patients with,fever was in celecoxib group. There were 7 cases in celecoxib group （14%）, 8 cases in Ibuprofen group （25%）, and 13 cases in blank control group （38.2%）, respectively. 2） The proportion of moderate fever （ 38. 1 - 39℃） and high fever （ 〉 39℃ ） in. celecoxib group was significantly lower than that in the other two groups, but the proportion of low fever （37.3 - 38℃） in celecoxib group was slightly higher than that in the other two groups. The proportion of different degree of fever was 4 cases of low fever （8%） , 2 cases of moderate fever （4%） , and 1 case of high fever （2%）, respectively, in celecoxib group; 3 cases of low fever （6.3%） , 3 cases of moderate fever （9.4%） , and 3 cases of high fever （9.4%）, respectively, in Ibuprofen group; 2 cases of low fever （5.9%）, 5 cases.of moderate fever （ 14.7% ）, and 6 cases of high fever （ 17.6% ）, respectively, in blank control group. The degree of fever among the three groups was significantly different （P 〈 0. 05）. 3） The incidence of adverse reaction such as muscle pain, bone and joint pain, flu like symptoms, gastrointestinal symptoms, dizziness, headache, and palpitation was the lowest in celecoxib group. Except palpitation and.skin rash, the incidence of other adverse reactions was significantly different among the 3 groups （ P 〈 0.05 ）. Conclusion The prophylactic use of celecoxib can reduce the occurrence of adverse reaction of zoledronic acid.