唑来膦酸治疗老年女性骨质疏松症所致急性期反应的临床分析

Analysis of acute-phase responses in elderly women receiving Zoledronic acid for osteoporosis

目的分析唑来膦酸治疗老年女性骨质疏松症所致急性期反应的影响因素。方法采用前瞻性队列研究方法,观察2014年12月至2016年1月在我科首次使用静脉唑来膦酸治疗的老年女性骨质疏松症患者,共96例,记录患者发生急性期反应的发生率。按是否出现急性期反应分为有急性期反应组和无急性期反应组,比较分析两组的年龄、腰椎骨密度T值、是否口服双膦酸盐、是否口服他汀类药物、是否口服激素、甲状旁腺激素(PTH)、体重指数(BMI)、碱性磷酸酶(ALP)、睾酮、血钙及白细胞的差异。结果 96例患者中共观察到52例出现急性期反应,发生率高达54.17%。有急性期反应组与无急性期反应组比较,腰椎骨密度T值和BMI差异具有统计学意义(P<0.05);而年龄、是否口服双膦酸盐、是否口服他汀类药物、是否口服激素、PTH、ALP、睾酮、血钙及白细胞两组比较差异无统计学意义(P>0.05)。结论老年女性骨质疏松症患者首次应用唑来膦酸治疗时出现急性期反应非常常见。BMD和BMI与急性期反应的发生具有相关性。

Objective To analyze factors associated with acute-phase responses（APR） in elderly women receiving Zoledronic acid for osteoporosis. Methods From December 2014 to January 2016,we conducted a prospective cohort study in 96 elderly women with diagnosed osteoporosis. The patients were treated with Zoledronic acid for the first time. The incidence of APR was recorded. All the patients were divided into APR group and non-APR group according to whether having APR. Age,BMD,oral bisphosphonate intake,oral statins intake,oral corticosteroid intake,PTH,BMI,ALP,testosterone,serum calcium and WBC were compared between the two groups. Results Fifty-two patients had APR（54. 17%）. BMD and BMI were significant different between the two groups,but age,oral bisphosphonate intake,oral statins intake,oral corticosteroid intake,PTH,ALP,testosterone,serum calcium and WBC showed no significant differences. Conclusion APR is common in elderly women receiving Zoledronic acid for osteoporosis for the first time. BMD and BMI are associated with the incidence of APR.