唑来膦酸与阿仑膦酸钠在脊柱骨质疏松性骨折经皮椎体成形术后的疗效比较

Comparison of effects between zoledronic acid and alendronate sodium combined with percutaneous vertebroplasty

目的比较唑来膦酸与阿仑膦酸钠在脊柱骨质疏松性骨折经皮椎体成形术后的疗效。方法选取该院2012年7月至2016年7月经皮椎体成形术后的严重骨质疏松患者36例,随机分为两组,分为唑来膦酸组与阿仑膦酸钠组,每组各18例,疗程均为连续治疗36个月。比较两组患者的术前、术后1、2、3年骨密度、有无再发骨折及骨代谢指标水平。结果两组骨密度差异比较无统计学意义(P>0.05)。两组再发骨折数差异无统计学意义(P>0.05)。唑来膦酸组患者治疗后血清β-CTX浓度低于阿仑膦酸钠组(P<0.05),唑来膦酸组患者治疗后血清P1NP浓度高于阿仑膦酸钠组(P<0.05)。结论唑来膦酸静脉滴注与阿仑膦酸钠口服均能够显著增加腰椎及股骨颈骨密度基值,降低β-CTX血清浓度及提高P1NP血清浓度,但对再骨折发生率无明显影响。

Objective To compare the efficacy of zoledronic acid and alendronate sodium after percutaneous vertebroplasty for osteoporotic fractures of the spine.Methods Thirty-six patients with severe osteoporosis after percutaneous vertebroplasty in the hospital from July 2012 to July 2016 were selected and divided into the zoledronic acid group and alendronate sodium group randomized,with 18 cases in each group,the treatment course was continuous for 36 months.Bone mineral density,recurrent fracture and bone metabolism of the two groups were compared before and after surgery at 1,2,3 years.Results There was no significant difference in bone mineral density between the two groups(P>0.05).The number of recurrent fractures in the two groups was not statistically significant(P>0.05),serumβ-CTX concentration in the zoledronic acid group was lower than that in the alendronate sodium group(P<0.05),serum P1NP concentration in the zoledronic acid group was higher than that in the alendronate sodium group(P<0.05).Conclusion Zoledronic acid and alendronate sodium can significantly increase the basic value of the bone mineral density in lumbar vertebra and femoral nec,decrease serumβ-CTX,increase P1NP,but it had nosignificant on the incidence of refracture.