唑来膦酸治疗老年骨质疏松患者的临床疗效观察

Observation of Clinical Efficacy of Zoledronic Acid in the Treatment of Elderly Patients With Osteoporosis

目的观察唑来膦酸注射液治疗老年骨质疏松患者的临床疗效。方法选取2012年6月~2014年6月在我科住院的老年骨质疏松患者92例,随机分为治疗组和对照组各46例,其中治疗组含胸腰椎骨质疏松性骨折患者5例,对照组6例,所有患者均长期服用钙剂（钙尔奇D 600 mg,2次/d）和骨化三醇（0.25μg,1次/d）,治疗组患者在上述药物治疗基础上给予唑来膦酸注射液（5 mg/l00 m1）静脉滴注1次。研究比较两组患者VAS疼痛评分、腰椎骨密度变化、1年内新发椎体骨折发生率的差异,并观察唑来膦酸使用过程中的不良反应。结果随访1年,两组患者共92例均获得随访,两组患者治疗后1年,治疗组患者VAS疼痛评分显著低于对照组,两组间比较,差异有统计学意义（P〈0.05）,治疗组患者腰椎骨密度提高较对照组明显,差异有统计学意义（P〈0.05）,1年内治疗组新发椎体骨折发生率低于对照组,且差异有统计学意义（P〈0.05）,部分静滴唑来膦酸患者出现发热、乏力、恶心等症状,口服非甾体类消炎药后2天内基本缓解。结论唑来膦酸可以提高骨质疏松症患者骨密度,有效降低老年骨质疏松患者的骨折发生率,并且可以明显缓解疼痛,提高患者生活质量。

Objective To observe the clinical efficacy of zoledronic acid injection in the treatment of elderly patients with osteoporosis.Methods 92 cases hospitalized in our department from June 2012 to June 2014 were selected and randomly divided into treatment group and control group（with 46 cases each）,with 5 cases of thoracolumbarosteoporotic fracture in the treatment group and 6 cases in the control group.All the patients had long-term use of calcium（Caltrate D 600 mg,bid.） and calcitriol（0.25 μg,qd）,and the patients in the treatment group were given zoledronic acid injection（5 mg / 100 ml） intravenous infusion besides the above treatment.The study compared the differences in VAS pain scores,changes in lumbar spine bone mineral density（lumbar spine BMD）,andoccurrence of new vertebral fracture within a year.The study also observed the adversereactions in the process of using zoledronic acid between two groups of patients.Results During one year of follow-up,a total of 92 cases were followed up in two groups.One year after treatment,VAS pain scores of patients in the treatment group were significantly lower than those in the control group,and the difference between two groups was statisticallysignificant（P〈0.05）; increase of lumbar spine BMD in patients of the treatment group was more obvious than that in the control group,and the difference was statistically significant（P〈0.05）; the incidence of new vertebral fractures in the treatment group within one year was lower than control group,and the difference was statistically significant（P〈0.05）; somepatients intravenously infused with zoledronic acid had fever,fatigue,nausea and other symptoms,and the symptoms were relieved with two-days oral administration of non-steroidal anti-inflammatory drugs.Conclusion Zoledronic acid can increase bone densityin patients with osteoporosis,reduce the incidence of fractures in elderly patients withosteoporosis,and can significantly relieve pain and improve the life quality of patients.