特立帕肽联合骨化三醇对老年骨质疏松性脊椎骨折患者PVP术后骨转换指标的影响

The Effect of Teriparatide Combined with Calcitriol on Bone Turnover Indicators in Elderly Patients with Osteoporotic Vertebral Fractures after PVP

目的:探讨特立帕肽联合骨化三醇对老年骨质疏松性脊椎骨折患者经皮椎体成形术(PVP)术后骨转换指标的影响。方法:选取福建医科大学附属福州市第一医院骨外科收治的80例老年骨质疏松性脊椎骨折患者的病历资料进行回顾性分析(2020年5月—2022年10月),根据治疗方式分为对照组(n=40)和观察组(n=40)。两组均行PVP,对照组术后予以骨化三醇治疗,观察组给予特立帕肽联合骨化三醇治疗。比较两组疗效、骨转换标志物、腰椎功能及疼痛程度。结果:两组相比,观察组总有效率高于对照组,差异有统计学意义(P<0.05);治疗后1个月,两组Ⅰ型胶原C末端肽(CTX-1)水平均降低,与对照组相比,观察组较低,差异均有统计学意义(P<0.05);两组Ⅰ型胶原氨基端延长肽(PⅠNP)、25羟维生素D_(3)[25(OH)D_(3)]水平、骨密度(BMD)均升高,与对照组相比,观察组均较高,差异均有统计学意义(P<0.05);治疗后1个月,两组腰椎功能均明显提高,疼痛显著缓解,与对照组相比,观察组均较优,差异均有统计学意义(P<0.05)。结论:特立帕肽联合骨化三醇可降低老年骨质疏松性脊椎骨折患者PVP术后疼痛程度,并改善相关功能障碍,改善骨转换水平,并提高疗效。

Objective:To investigate the effect of Teriparatide combined with Calcitriol on bone turnover indicators after percutaneous vertebroplasty(PVP)in elderly patients with osteoporotic vertebral fractures.Method:A retrospective analysis was conducted on the case data of 80 elderly patients with osteoporotic vertebral fractures admitted to the Department of Orthopedics,Fuzhou First Hospital Affiliated to Fujian Medical University(May 2020 to October 2022).They were divided into the control group(n=40)and the observation group(n=40)based on the treatment method.Both groups underwent PVP,while the control group received postoperative treatment with Calcitriol,while the observation group received treatment with Teriparatide combined with Calcitriol.The efficacy,bone turnover markers,lumbar function,and pain level between the two groups of patients were compared.Result:Compared with the control group,the total effect rate of the observation group was higher,the difference was statistically significant(P<0.05).One month after treatment,the levels of typeⅠcollagen C-terminal peptide(CTX-1)in both groups decreased,and compared with the control group,the observation group was lower,the differences were statistically significant(P<0.05);the levels of type procollagenⅠN-terminal propeptide(PⅠNP),25 hydroxyvitamin D3[25(OH)D3],and bone mineral density(BMD)in both groups increased,compared with the control group,the observation group had a higher level,the differences were statistically significant(P<0.05).One month after treatment,both groups of patients showed significant improvement in lumbar function and pain relief,compared with the control group,the observation group showed better results,the differences were statistically significant(P<0.05).Conclusion:The combination of Teriparatide and Calcitriol can reduce the postoperative pain level of elderly patients with osteoporotic vertebral fractures after PVP,improve related dysfunction,improve bone turnover levels,and improve patient efficacy.