唑来膦酸联合依降钙素对骨质疏松骨折患者术后骨痛及骨折愈合的影响

Effect of zoledronic acid combined with elcatonin on postoperative bone pain and fracture healing in osteoporotic fracture patients

目的分析唑来膦酸联合依降钙素对骨质疏松骨折患者术后骨痛及骨折愈合的影响。方法选择2020年4月至2021年6月间收治于本院的100例骨质疏松骨折术后患者作为研究对象,对照组(50例)采用唑来膦酸5 mg治疗,试验组(50例)采用唑来膦酸5 mg联合依降钙素10 U治疗,评估2组患者的临床疗效、视觉模拟评分法(VAS)及Oswestry功能障碍指数(ODI),检测2组患者的骨密度及骨折愈合指标。结果治疗后,试验组患者的总有效率(96.00%)明显高于对照组(80.00%);试验组患者的股骨颈、腰椎的骨密度分别为(0.94±0.12)和(0.91±0.10)g·cm^(-3),对照组患者的股骨颈、腰椎的骨密度分别为(0.82±0.12)和(0.81±0.08)g·cm^(-3);试验组患者的血清碱性磷酸酶(ALP)、胰岛素样生长因子(IGF)、I型前胶原羧基端肽(PICP)和骨钙素(OC)水平分别为(5.47±0.81)%、(8.21±1.24)μg·L^(-1)、(143.77±6.68)mg·L^(-1)和(20.48±3.21)ng·mL^(-1),对照组患者的血清ALP、IGF、PICP和OC水平分别为(4.89±0.89)%、(5.99±1.56)μg·L^(-1)、(133.04±7.58)mg·L^(-1)和(18.43±3.26)ng·mL^(-1)。治疗后9个月,试验组和对照组患者的VAS评分分别为(0.33±0.17)和(0.41±0.10)分;试验组和对照组患者的ODI评分分别为(18.08±1.69)和(21.88±2.10)分。上述指标,试验组与对照组相比,差异均有统计学意义(P<0.05)。试验组患者的不良反应总发生率(6.00%)稍高于对照组(4.00%),差异无统计学意义(P>0.05)。结论唑来膦酸联合依降钙素可有效缓解骨质疏松骨折患者术后骨痛及功能障碍情况,安全性较高,具有一定的临床应用价值。

Objective To analyze the effect of zoledronic acid combined with elcatonin on postoperative bone pain and fracture healing in osteoporotic fracture patients.Methods A total of 100 postoperative patients with osteoporosis fracture treated in our hospital from April 2020to June 2021 were selected as the study subjects.The control group(50cases)was treated with zoledronic acid 5 mg,and the treatment group(50 cases)was treated with zoledronic acid 5 mg combined with elcatonin 10 U.Clinical efficacy,visual analogue scale(VAS)and Oswestry disability index(ODI)were evaluated,and bone minera density and fracture healing indexes were determined.Results After treatment,the total effective rate in the treatment group(96.00%)was significantly higher than that in the control group(80.00%).The bone mineral density of femoral neck and lumbar spine in the treatment group were(0.94±0.12)and(0.91±0.10)g·cm^(-3),respectively,while those in the control group were(0.82±0.12)and(0.81±0.08)g·cm^(-3),respectively.The levels of serum alkaline phosphatase(ALP),insulin-like growth factor(IGF),carboxy-terminal peptide of type I procollagen(PICP)and osteocalcin(OC)in the treatment group were(5.47±0.81)%,(8.21±1.24)μg·L^(-1),(143.77±6.68)mg·L^(-1)and(20.48±3.21)ng·m L^(-1),respectively.The levels of serum ALP,IGF,PICP and OC in the control group were(4.89±0.89)%,(5.99±1.56)μg·L^(-1),(133.04±7.58)mg·L^(-1)and(18.43±3.26)ng·m L^(-1),respectively.At 9 months after treatment,the VAS scores in the treatment group and control group were(0.33±0.17)and(0.41±0.10)points,respectively.The ODI scores of patients in the treatment and control group were(18.08±1.69)and(21.88±2.10)points,respectively.Compared with the control group,there were statistically significant differences in the treatment group(P<0.05).The total incidence of adverse reactions in treatment group(6.00%)was slightly higher than that in control group(4.00%),and the difference was not statistically significant(P>0.05).Conclusion Zoledronic acid combined with elcatonin can effectively relieve postoperative bone pain and dysfunction in osteoporotic fracture patients,with high safety,and has certain clinical application value.