唑来膦酸联合钙尔奇对老年绝经后骨质疏松症患者疼痛情况的影响

Effect of zoledronic acid combined with caltrate on pain in elderly postmenopausal patients with osteoporosis

目的:探究唑来膦酸联合钙尔奇对老年绝经后骨质疏松症患者疼痛情况的影响。方法:选取本院2019年2月1日—2021年12月31日符合条件的80例老年绝经后骨质疏松症患者,按照抽签法分为对照组和试验组各40例。对照组给予钙尔奇片600 mg/次,2次/d;试验组在对照组的基础上联用唑来膦酸5 mg静脉滴注,滴注时间≥15 min,滴注前后予500 ml氯化钠注射液水化,1年1次即可。评估两组患者临床疗效、骨密度、血清指标、疼痛情况、骨代谢及不良反应。结果:试验组总有效率高于对照组(P<0.05)。治疗前两组腰椎、股骨颈和股骨大转子水平比较无统计学差异(P>0.05);治疗后试验组腰椎、股骨颈和股骨大转子水平均高于对照组(P<0.05)。治疗前两组血清甲状旁腺素(PTH)和25-羟基维生素D3[25(OH)D_(3)]水平比较无统计学差异(P>0.05);治疗后试验组血清PTH水平高于对照组,而25(OH)D_(3)低于对照组(P<0.05)。治疗前两组视觉模拟评分(VAS)比较无统计学差异(P>0.05);治疗后试验组VAS评分低于对照组(P<0.05)。治疗前两组骨代谢指标比较无统计学差异(P>0.05);治疗后试验组骨特异性碱性磷酸酶(BALP)、血钙(Ca)、血磷(P)、降钙素(hCT)和骨钙素(BGP)水平均高于对照组,其中两组BALP、Ca和hCT差异有统计学意义(P<0.05),而两组P和BGP水平差异无统计学意义(P>0.05),β-胶原片段(β-CTX)低于对照组(P<0.05)。两组不良反应总发生率比较无统计学差异(P>0.05)。结论:唑来膦酸联合钙尔奇可有效缓解老年绝经后骨质疏松症患者疼痛程度,提高临床疗效,改善骨密度和骨代谢,降低炎症因子水平。

Objective:To investigate the effects of zoledronic acid combined with caltrate on pain in elderly postmenopausal patients with osteoporosis.Methods:A total of 80 eligible elderly postmenopausal patients with osteoporosis in our hospital from February 1,2019,to December 31,2021,were selected and divided into a control group and an experimental group(n=40)according to the lottery method.The control group was treated with caltratetablets 600 mg/time,twice/day.The experimental group was given an intravenous infusion of zoledronic acid 5 mg on the basis of the control group.The infusion time was≥15 min,and 500 ml sodium chloride injection was hydrated before and after infusion once a year.The clinical efficacy,bone mineral density,serum indexes,pain,bone metabolism,and adverse reactions of the two groups were evaluated.Results:The total effective rate of the experimental group was higher than that of the control group(P<0.05).Before treatment,there were no differences in the levels of lumbar spine,femoral neck,and greater trochanter between the two groups(P>0.05).After treatment,the levels of lumbar spine,femoral neck,and greater trochanter of the experimental group were higher than those of the control group(P<0.05).There were no significant differences in serum parathyroid hormone(PTH)and 25-hydroxyvitamin D3[25(OH)D_(3)]levels between the two groups before treatment(P>0.05).After treatment,the serum PTH level of the experimental group was higher than that of the control group,while the 25(OH)D_(3) level was lower than that of the control group(P<0.05).There was no significant difference in the visual analogue score(VAS)between the two groups before treatment(P>0.05).The VAS score of the experimental group was lower than that of the control group after treatment(P<0.05).There was no significant difference in bone metabolism between the two groups before treatment(P>0.05).After treatment,the levels of BALP,Ca,hCT,P,and BGP in the test groups were higher than those in the control group.There was statistical significance in BALP,Ca,and hCT between the two groups(P<0.05),while there was no statistical significance in P and BGP levels between the two groups(P>0.05),andβ-CTX was lower than that in the control group(P<0.05).The total incidence of adverse reactions in the experimental group was lower than that in the control group(P>0.05).Conclusions:Zoledronic acid combined with caltratetablets can effectively relieve the pain of elderly postmenopausal osteoporosis patients,improve clinical efficacy,improve bone mineral density and bone metabolism,and reduce inflammatory factors.