老年股骨粗隆间骨折术后患者应用唑来膦酸联合碳酸钙D_(3)治疗对髋关节功能及骨代谢指标的影响

Effect of Zoledronic Acid combined with Calcium Carbonate D_(3) on Hip Function and Bone Metabolism Indexes in Elderly Patients after in Tertrochanteric Fracture

目的 探讨老年股骨粗隆间骨折患者采用唑来膦酸联合碳酸钙D_(3)治疗对髋关节功能及骨代谢指标的影响。方法选取2020年1月至2022年1月宜春市人民医院关节外科收治的70例老年股骨粗隆间骨折患者作为研究对象,按照随机抽签法分为观察组(n=35)与对照组(n=35)。对照组采用碳酸钙D_(3)治疗,观察组在对照组基础上联合唑来膦酸治疗。比较两组术后骨折愈合时间,治疗前后Harris髋关节评分(HSS)、骨密度、钙磷代谢及骨形成标志物[骨碱性磷酸酶(BALP)、骨钙素(BGP)、Ⅰ型前胶原氨基末端前肽(PINP)]变化,观察两组不良反应发生情况。结果 观察组术后骨折愈合时间短于对照组(P<0.05)。治疗后两组HSS较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后两组股骨粗隆、股骨颈的骨密度较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后两组血钙、磷水平较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后两组BGP、PINP、BLAP水平高于治疗前(P<0.05),且观察组高于对照组(P<0.05)。两组均未发生严重不良反应。结论 老年股骨粗隆间骨折患者术后采用唑来膦酸联合碳酸钙D_(3)治疗,可促进骨折愈合,提升髋关节功能,增加骨密度,改善骨代谢水平,且安全性较高。

Objective To explore the effects of zoledronic acid combined with calcium carbonate D_(3) on hip function and bone metabolism indexes in elderly patients with intertrochanteric fracture of femur.Methods Seventy elderly patients with intertrochanteric fracture of femur admitted to the Department of Joint Surgery of Yichun People's Hospital from January 2020 to January 2022 were selected as the study objects,and were divided into observation group(n=35)and control group(n=35)according to random drawing method.The control group was treated with calcium carbonate D_(3),and the observation group was treated with zoledronic acid based on the control group.The postoperative fracture healing time,Harris hip score(HSS),bone mineral density,calcium and phosphorus metabolism and bone formation markers(bone alkaline phosphatase(BALP),osteocalcin(BGP),amino terminal propeptide of typeⅠprocollagen(PINP)before and after treatment were compared between the two groups,and the occurrence of adverse reactions was observed.Results The healing time of fracture in the observation group was shorter than that in the control group(P<0.05).After treatment,the HSS of the two groups was higher than that before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).After treatment,the bone mineral density of femoral trochanter and femoral neck in both groups was higher than before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).After treatment,the levels of calcium and phosphorus in the two groups were higher than those before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).After treatment,the levels of BGP,PINP and BLAP in the two groups were higher than before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).No serious adverse reactions occurred in the two groups.Conclusion Postoperative treatment with zoledronic acid combined with calcium carbonate D_(3) in elderly patients with intertrochanteric fracture of femur can promote fracture healing, improve hip joint function, increase bone density and improve bone metabolism level, and is safe.