唑来磷酸钠联合骨化三醇治疗原发性骨质疏松症的疗效观察

Observation of curative effect of zolai sodium phosphate combined with trialcohol in treatment of primary osteoporosis

目的探讨唑来磷酸钠联合骨化三醇治疗骨质疏松症的临床效果。方法前瞻性收集2012年10月至2017年10月天津市泰达医院收治的203例骨质疏松症患者,采用随机数字表法将其分为唑来磷酸钠组(A组)和唑来磷酸钠联合骨化三醇(B组),A组102例,B组101例,比较两组患者治疗前后的骨密度变化、骨代谢情况、不良反应等情况。结果203例患者均获得完整随访,随访率100%,随访时间3~5年,平均(3.9±0.5)年。治疗前两组患者的髋部骨密度[A组(0.557±0.052)g/cm3,B组(0.554±0.056)g/cm3]、腰椎骨密度[A组(0.669±0.047)g/cm3,B组(0.670±0.047)g/cm3]无明显差异,治疗后腰椎骨密度水平[A组(0.863±0.023)g/cm3,B组(0.870±0.021)g/cm3]均有显著改善,与治疗前相比,差异均有统计学意义(t=38.661,t=38.152,P<0.05),髋部骨密度水平均有改善[A组(0.720±0.023)g/cm3,B组(0.750±0.044)g/cm3],与治疗前相比,差异均有统计学意义(t=28.653,t=32.533,P<0.05),治疗后组间差异有统计学意义(t=2.001,t=5.921,P<0.05);两组患者治疗前血钙指标[A组(2.200±0.059)mmol/L,B组(2.201±0.054)mmol/L]无明显差异,治疗后[A组(2.211±0.060)mmol/L,B组(2.323±0.044)mmol/L]B组血钙变化明显,与A组比较差异有统计学意义(P<0.05)。B组(15.8%)的不良反应发生率低于A组(33.3%),两组患者均无严重药物不良反应发生。结论唑来磷酸钠联合骨化三醇可提高骨质疏松患者骨密度,改善骨代谢状态,并且降低药物不良反应的发生率。

Objective To investigate the clinical effect of sodium zoledronate combined with calcitriol in the treatment of osteoporosis.Methods A prospective study of 203 patients with osteoporosis admitted to Tianjin TEDA Hospital from October 2012 to October 2017 was divided into three groups:the sodium zoledronate group(group A)and the combination of sodium zoledronate.Calcitriol(group B),102 patients in group A and 101 patients in group B.The changes of bone mineral density,bone metabolism and adverse reactions were observed before and after treatment.All the 203 patients had been followed,The rate was 100%and lasted 3-5 years(3.891±0.501 on average).There was no significant difference in bone mineral density of the hip[group A(0.557±0.052)g/cm3,group B(0.554±0.056)g/cm3]and the lumbar vertebrae[group A(0.669±0.047)g/cm3,group B(0.670±0.047)g/cm3]between the two groups before treatment.The bone mineral density of the lumbar vertebrae improved after treatment[group A(0.863±0.023)g/cm3,group B(0.870±0.021)g/cm3],compared with before treatment,the difference was statistically significant(t=38.661,t=38.152,P<0.05).The hip bone mineral density level was improved[group A(0.720±0.023)g/cm3,group B(0.750±0.044)g/cm3],compared with before treatment,the difference was statistically significant(t=28.653,t=32.533,P<0.05).There was significant difference between the two groups after treatment(t=2.001,t=5.921,P<0.05),there was no significant difference in blood calcium index between the two groups before treatment[group A(2.200±0.059)mmol/L,group B(2.201±0.054)mmol/L].The blood calcium in group B was significantly changed after treatment [group A (2.211±0.060) mmol/L, group B (2.323±0.044) mmol/L],and the difference was statistically significant (P<0.05). The incidence of adverse reactions in group B(15.8%) was lower than that in group A (33.3%), and no serious adverse drug reactions occurred in eithergroup. Conclusion Sodium zoledronate combined with calcitriol can increase bone mineral density, improvebone metabolism and reduce the incidence of adverse drug reaction-s in patients with osteoporosis.