唑来膦酸治疗老年骨质疏松症合并COPD患者的临床疗效

Clinical effectiveness of Zoledronic acid in the treatment of senile osteoporosis patients with COPD

目的研究唑来膦酸注射液(zoledronic acid,ZOL)治疗老年骨质疏松症合并慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者的临床疗效。方法选择在珠海市人民医院骨科住院治疗的46例骨质疏松合并COPD患者,给予唑来膦酸、钙尔奇D及骨化三醇治疗,疗程均为1年,分别测量患者治疗前后腰椎、髋部骨密度(bone mineral density,BMD)、肺功能、血清中血钙、血磷、血清骨钙素(BGP)、骨源性碱性膦酸酶(BALP)及VAS疼痛评分,进行统计学研究分析其变化。结果患者治疗12个月后VAS疼痛评分降低,一秒用力呼气容积(forced expiratory volume in one second,FEV1)、一秒用力呼气量与用力肺活量比值(FEV1%)显著提高,腰椎、髋部BMD明显提高,比较差异有统计学意义(P <0. 05);BGP较治疗前明显升高,BALP较治疗前明显降低,比较差异有统计学意义(P <0. 05),血钙、血磷保持平稳,比较差异无统计学意义(P>0. 05)。结论唑来膦酸改善了患者的骨代谢情况,提高了骨密度,同时使患者的肺通气功能得到了改善,可以安全有效的治疗老年骨质疏松症合并COPD。

Objective To study the clinical effect of zoledronic acid( ZOL) in treating senile osteoporosis patients with chronic obstructive pulmonary disease( COPD). Methods Randomly choosing 46 osteoporosis patients with COPD in the Orthopaedic Department of Zhuhai People’s Hospital who received zoledronic acid treatment,and compared the changes in BMD( lumbar spine,femoral neck),pulmonary function,blood Ca,blood P,BGP,BALP and VAS score. Results After 12 months of treatment,VAS pain score was decreased,forced expiratory volume in one second( FEV1) and FEV1% were significantly increased,lumbar spine and hip BMD were significantly increased,and the differences were statistically significant( P<0. 05). BGP was significantly higher and BALP was significantly lower than before treatment,and the differences were statistically significant( P< 0. 05). The levels of blood Ca and blood P did not change,and the difference was not statistically significant( P > 0. 05). Conclusion Zolledronic acid could improve bone metabolism and bone density in patients,and at the same time improved pulmonary function,therefore could prevent and cure senile COPD osteoporosis safely and effectively.