唑来膦酸治疗绝经后骨质疏松的疗效及影响因素分析

Efficacy and influencing factors of zoledronic acid in the treatment of postmenopausal osteoporosis

目的:探究唑来膦酸在绝经后骨质疏松患者的治疗中对骨密度的提升效果及影响因素。方法:回顾性分析2011年8月至2020年3月于本科首次应用唑来膦酸治疗的绝经后骨质疏松患者治疗前及治疗1年后的骨密度改变,并分析其影响因素。结果:本研究共纳入44人,唑来膦酸治疗1年后,患者腰椎骨密度及髋关节骨密度较治疗前分别提高(5.4±8.7)%及(3.0±8.0)%(P=0.001、0.039)。相关性分析显示,腰椎骨密度变化与用药前腰椎骨密度及随访时空腹血糖呈负相关。髋关节骨密度变化与用药前髋关节骨密度呈负相关。logisic回归分析显示,腰椎基础骨密度低是腰椎骨密度明显改善的有利因素[OR=6.78,95%CI(1.30~35.43)],而2型糖尿病是腰椎骨密度明显改善的不利因素[OR=0.16,95%CI(0.03~0.98)]。结论:唑来膦酸可以显著提升绝经后骨质疏松患者腰椎及髋关节骨密度,腰椎基础骨密度及2型糖尿病可能影响其对腰椎骨密度的改善效果。

Objective:To evaluate the efficacy and risk factors of zoledronic acid in the treatment of postmenopausal osteoporosis.Methods:Forty-four patients with postmenopausal osteoporosis who treated with zoledronic acid in our department during August2011 to March2020 were enrolled in this retrospective analysis.The changes of bone mineral density(BMD)and the associations between the changes of BMD and demographic characteristics,clinical parameters were examined.Results:After 1 year,the BMD of lumber vertebra and total hip were increased by(5.4±8.7)%and(3.0±8.0)%than BMD before treatment respectively(P=0.001 and 0.039).Correlation analysis showed that the change of lumber vertebra BMD was negatively correlated with the basal lumber vertebra BMD and fasting blood glucose when follow up.The change of total hip BMD was negatively correlated with the basal total hip BMD.In the logistic regression analysis,the ORs for improvement of lumber vertebra BMD of basal lumber vertebra and type 2 diabetes were 6.78(1.30~35.43)and 0.16(0.03~0.98)respectively.Conclusion:Zoledronic acid can significantly improve the bone mineral density of lumbar vertebra and total hip hip in postmenopausal osteoporosis patients.Basal lumbar vertebra BMD and type 2 diabetes may affect the improvement of lumbar vertebra BMD when treated with zoledronic acid.