唑来膦酸在老年骨质疏松性脊柱骨折患者中的疗效及对骨转换的影响

Effect of Zoledronic Acid in Elderly Patients with Osteoporotic Spinal Fracture and Influence on Bone Turnover

目的:探究唑来膦酸在老年骨质疏松性脊柱骨折患者中的疗效及对骨转换的影响。方法:将2019年10月-2021年3月宁德师范学院附属宁德市医院收治的110例老年骨质疏松性脊柱骨折患者,用随机数字表法分为对照组和观察组,各55例。对照组采用椎体成形术进行治疗,观察组在对照组基础上加用唑来膦酸治疗。比较两组治疗前后的Oswestry功能障碍指数(ODI)、视觉模拟评分法(VAS)评分、结构参数(Cobb角、椎间隙高度及椎管占位率)及骨转换指标[血清Ⅰ型胶原交联N端肽(NTX)、Ⅰ型胶原交联C端肽(CTX)及抗酒石酸酸性磷酸酶(TRAP)]。结果:治疗前,两组ODI、VAS评分、结构参数及骨转换指标比较,差异均无统计学意义(P>0.05);治疗后6、12个月,两组ODI、VAS评分、结构参数及骨转换指标均显著优于治疗前,且观察组均显著优于对照组(P<0.05)。结论:唑来膦酸在老年骨质疏松性脊柱骨折中的应用效果较好,可有效减轻患者疼痛,改善骨转换状态及脊柱功能。

Objective: To investigate the effect of Zoledronic Acid in elderly patients with osteoporotic spinal fracture and influence on bone turnover. Method: A total of 110 elderly patients with osteoporotic spinal fractures who were admitted to Ningde Municipal Hospital of Ningde Normal University from October 2019 to March 2021were divided into a control group and an observation group according to the random number table method, 55 cases in each group. The control group was treated with vertebroplasty, and the observation group was additionally treated with Zoledronic Acid on the basis of the control group. The Oswestry disability index(ODI), visual analogue scale(VAS) score, structural parameters(Cobb angle, intervertebral space height and space occupying rate of vertebral canal) and bone turnover indexes [serum type Ⅰ collagen crosslinkn N-terminal telopeptide(NTX), type Ⅰ collagen crosslinkn C-terminal telopeptide(CTX) and tartrate resistant acid phosphatase(TRAP)] were compared between the two groups before and after treatment. Result: Before treatment, there were no significant differences in ODI, VAS scores, structural parameters and bone turnover indexes between the two groups(P>0.05). 6 and 12 months after treatment, the ODI, VAS scores, structural parameters and bone turnover indexes of the two groups were significantly better than those before treatment, and the observation group were significantly better than those in the control group(P<0.05). Conclusion: Zoledronic Acid has good application effect in elderly patients with osteoporotic spinal fracture, it can effectively relieve pain, improve bone turnover, and spinal function.