唑来膦酸联合阿法骨化醇及碳酸钙D3治疗原发性骨质疏松症的效果分析

Effect of zoledronic acid combined with afacalcitol and calcium carbonate D3 on primary osteoporosis

目的分析唑来膦酸联合阿法骨化醇、碳酸钙D3治疗原发性骨质疏松症的效果。方法抽取2018年9月至2021年5月联勤保障部队第九八八医院焦作院区收治的原发性骨质疏松患者92例,按照随机数字表法分为对照组与研究组,每组46例。对照组采用唑来膦酸治疗,研究组在对照组基础上采用阿法骨化醇、碳酸钙D3治疗。比较两组治疗效果、视觉模拟评分法(VAS)评分、骨代谢指标[骨钙素(BGP)、骨特异性碱性磷酸酶(BALP)、骨形态发生蛋白-2(BMP-2)]、骨密度(BMD)水平及不良反应发生率。结果研究组总有效率(95.65%,44/46)高于对照组(76.09%,35/46),P<0.05;治疗后3、6、12个月,研究组VAS评分均低于对照组(P均<0.05);治疗后,研究组BGP、BALP、BMP-2水平均高于对照组(P均<0.05);治疗后,研究组全髋、第2~4腰椎、股骨颈BMD水平高于对照组(P<0.05);研究组腹泻、肌肉酸痛、疲劳、发热发生率与对照组比较差异未见统计学意义(P>0.05)。结论唑来膦酸联合阿法骨化醇、碳酸钙D3治疗原发性骨质疏松疗效显著,能明显改善疼痛症状,调节骨代谢和骨密度,且治疗安全性高。

Objective To analyze the effect of zoledronic acid combined with afacalcitol and calcium carbonate D3 in the treatment of primary osteoporosis.Methods A total of 92 patients with primary osteoporosis treated in the 988 Hospital of the Joint Logistic Support Force from September 2018 to May 2021 were selected,and they were divided into a single group and a combined group according to the random number table method,with 46 case in each group.The single group was treated with zoledronic acid,and the combined group was treated with afacalcitol and calcium carbonate D3 based on the treatment of the single group.The curative effect,visual analogue scale(VAS)score,bone metabolism indexes including bone mineral density(BGP),bone specific alkaline phosphatase(BALP)and bone morphogenetic protein-2(BMP-2),levels of bone mineral density and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the combined group(95.65%,44/46)was higher than that of the single group(76.09%,35/46),P<0.05.The VAS scores of the study group were lower than those of the control group after 3 months,6 months and 1 year of treatment(P<0.05).The levels of BGP,BALP and BMP-2 in the combined group were higher than that of the control group after treatment(all P<0.05).The levels of BMD of total hip,the 2rd lumbar vertebra to the 4th lumbar vertebra and femoral neck in the combined group were higher than those in the control group after treatment(P<0.05).There was no significant difference in the incidence of diarrhea,muscle pain,fatigue and fever between the study group and the control group(P>0.05).Conclusions Zoledronic acid combined with afacalcitol and calcium carbonate D3 has a significant curative effect in the treatment of primary osteoporosis,moreover,it can significantly improve pain symptoms,regulate bone metabolism and bone density,with high safety.