地舒单抗对骨质疏松性椎体压缩骨折术后患者骨代谢指标及临床效果的影响

Effect of denosumab on bone metabolism and clinical effect in patients with osteoporotic vertebral compression fracture

目的研究地舒单抗(denosumab)对骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)术后患者血清骨代谢指标[1型胶原氨基端延长肽(P1NP)和1型胶原羟基端肽(β-CTX)]及临床应用效果的影响。方法选取2020年7月至2021年6月在西安兵器工业五二一医院就诊的50例绝经后OVCF患者作为研究对象,排除手术禁忌后行椎体后凸成形术,术后注射地舒单抗治疗,同时与2017年5月至2020年1月50例行椎体后凸成形术未给予地舒单抗病例相对比,比较2组患者骨代谢指标及临床效果。结果全部患者手术完成顺利。观察组与对照组术后3个月、6个月、9个月的P1NP和β-CTX值相比较,差异有统计学意义(P<0.05)。至末次随访时,所有病例未出现神经症状,椎体未发现塌陷,观察组患者未发生再次椎体骨折,对照组中2例患者发生临近椎体骨折,再骨折率为4%(2/50)。结论地舒单抗应用于OVCF术后患者,能有效改善骨代谢,缓解临床症状,降低再骨折发生率。

Objective To study the effects of denosumab on serum bone metabolism indexes(P1NP andβ-CTX)in patients with osteoporotic vertebral compression fracture and clinical application effect.Methods Fifty patients with postmenopausal osteoporosis with vertebral brittle fracture treated in Weapon Industry 521 Hospital from July 2020 to June 2021 were selected as the research objects.After excluding the surgical con-traindications,kyphoplasty was performed.At the same time,compared with 50 cases who underwent kyphoplasty without desudan from May 2017 to January 2020,the bone metabolism indexes and clinical effects of the two groups were recorded.Results P1NP andβ-CTX were measured 3 months,6 months and 9 months after operation in the observation group and the control group,the difference was statistically significant(P<0.05).At the last fol-low-up,no neurological symptoms and no collapse of vertebral body were found in all cases.There was no reverte-bral fracture in the observation group,and 2 patients in the control group had adjacent vertebral fracture,with a refracture rate of 4%(2/50).Conclusion Denosumab can effectively alleviate clinical symptoms,improve bone metabolism and reduce the incidence of refracture in patients with osteoporotic vertebral compression fracture.