鲑鱼降钙素在老年患者全髋关节置换术中的应用分析

Application of salmon calcitonin in elder patient's total hip arthroplasty

目的观察鲑鱼降钙素对老年患者全髋关节置换术中骨代谢、关节功能恢复及生活质量的影响,评价其临床价值。方法对沈阳市骨科医院134例60岁以上行全髋关节置换术的老年患者随机分为观察组(67例)和对照组(67例),观察组给予鲑鱼降钙素干预,随访6个月,检测骨代谢指标血清骨钙素(osteocalcin,OC)、骨碱性磷酸酶(bone alkaline phosphatase,BALP)、Ⅰ型胶原交联C端肽(C-terminal telopeptides of typeⅠcollagen,β-CTX)、Ca^(2+)水平及骨密度(bone mineral density,BMD),疼痛强度差(pain intensity difference,PID)关节功能及生活质量评分。结果术后1、3、6个月血清OC观察组均高于对照组(P<0.05);血清β-CTX观察组在3、6个月低于对照组(P<0.05);血清BALP在术后1、3、6个月对比观察组均低于对照组(P<0.05);血清Ca^(2+)术后3、6个月观察组高于对照组(P<0.05);BMD术后1、3、6个月观察组高于对照组(P<0.05);观察组早期疼痛PID评分在3、6个月高于对照组(P<0.05);直腿抬高30°时间观察组短于对照组(P<0.05);髋关节外展45°观察组短于对照组(P<0.01);Harris评分观察组高于对照组(P<0.05);SF-36平均分观察组高于对照组(P<0.05)。结论鲑鱼降钙素在老年人全髋关节置换术中应用可促进成骨过程,抑制破骨过程,减轻患者早期疼痛,促进关节功能恢复及改善生活质量。

Objective To observe the effect of salmon calcitonin on bone metabolism, joint function recovery and life quality of elder patients after total hip anthroplasty and evaluate the clinical value. Methods 134 patients above sixty who underwent total hip arthroplasty were divided into observation group（67 cases） and control group（67 cases） in Shenyang Osteological Hospital. Salmon calcitonin was given to observation group, followed by a follow-up of six months. Ser um osteocalcin（OC）, C-ter minal telopeptides of type Ⅰ collagen（β-CTX）, bone alkaline phosphatase（BALP）, Ca2＋, bone mineral density（BMD）, pain intensity differences（PID）, joint function and life quality scores were detected. Results The level of serum OC in observation group was higher than in control group 1, 3 and 6 month post-operatively（P〈0.05） while the level of serum β-CTX in observation group was lower than in control group 3 and 6 months post-operatively（P〈0.05）. The level of serum BALP in observation group was lower than in control group 1, 3, and 6 months post-operatively（P〈0.05）. The level of serum Ca2＋ in observation group was higher than in control group 3 and 6 months post-operatively（P〈0.05）. BMD in observation group was higher than in control group 1, 3 and 6 months post-operatively（P〈0.05）. The long-term pain PID score in observation group was higher than in control group（P〈0.05）. Straight leg-raising 30° time in observation group was shorter than in control group（P〈0.05）. Hip adducting 45° in observation group was shorter than in control group（P〈0.01）. Harris score in observation group was higher than in control group（P〈0.05）. SF-36 scores in observation group were higher than in control group（P〈0.05）. Conclusion Salmon calcitonin can promote ossification, inhibit osteolysis, relieve long-term pain, facilitate joint function recovery and improve life quality in elder patients after total hip arthroplasty.