骨矿化物治疗对老年骨质疏松患者平衡能力的影响及效果分析

Effects of oral calcium and active vitamin D on bone mineral density and balance function in senile osteoporosis patients

目的 探讨口服骨矿化物对老年骨质疏松患者骨密度、平衡能力、跌倒发生率及骨痛的影响。 方法 采用前瞻性自身对照的研究方法，收集符合纳入标准的老年骨质疏松患者216例，给予口服骨矿化物（钙剂及活性维生素D），疗程12个月，比较治疗前及治疗后6个月、12个月老年骨质疏松患者的骨密度、平衡能力、跌倒次数及骨痛变化情况。 结果 治疗前与治疗后12个月比较，老年骨质疏松患者腰椎及左右髋骨密度、静态平衡能力（采用闭目单脚站立测试）、动态平衡能力（采用星型伸展平衡测试）在东、东南、南、西南四个方向差异有统计学意义（P〈0.05）；治疗后12个月内跌倒发生率（5.6%）较治疗前（12.5%）有所下降，而治疗前后骨痛评估差异无统计学意义（P〉0.05）。 结论 骨矿化物可有效提高老年骨质疏松患者的骨密度，改善其平衡能力，降低跌倒风险，但是短期内对骨痛程度改善不明显。

Objective To investigate the effects of oral calcium and active vitamin D on bone mineral density and balance function in senile osteoporosis patients. Methods A prospective case- control study was conducted on 216 senile osteoporosis patients who met the inclusion criteria. Patients were given oral calcium and active vitamin D for 12 months. The data values of BMD, balance function, falls incidence and bone pain were compared before versus 6 and 12 months after treatment. Results There were significant differences in BMD of lumbar vertebrae and femur neck, static balance function assessed by the single-leg stance timed tests with closed eyes, dynamic balance function assessed by the Star Excursion Balance Test（SEBT） in directions of east, southeast, south and southwest（all P〈0.05）. The incidence of falls was decreased 12 months after treatment as compared with pre-treatment（5.6% vs. 12.5%）. The bone pain had no significant difference before versus after treatment（P〉0.05）. Conclusions Oral calcium and active vitamin D could increase BMD, improve the balance function and decrease the risk of falls in senile osteoporosis patients. However, it has no significant improvement on bone pain within a short period.