地舒单抗注射液对绝经后骨质疏松患者骨密度、骨代谢指标的影响

Effect of Denosumab Injection on Bone Density and Bone Metabolism Indicators in Patients with Postmenopausal Osteoporosis

目的:探究地舒单抗注射液对绝经后骨质疏松(PMO)患者骨密度、骨代谢指标的影响。方法:回顾性分析2021年1月—2022年10月南昌市洪都中医院收治的80例PMO患者,根据用药方式的不同分为地舒单抗组(常规治疗基础上接受地舒单抗注射液治疗)和常规组(常规治疗),各40例,分析两组临床疗效、骨密度、骨代谢、钙磷代谢、疼痛程度及不良反应发生情况。结果:地舒单抗组总有效率显著高于常规组,差异有统计学意义(P<0.05)。治疗6、12个月后,两组腰椎骨密度、股骨颈骨密度均显著高于治疗前,且地舒单抗组均显著高于常规组,差异均有统计学意义(P<0.05)。治疗6、12个月后,两组Ⅰ型胶原氨基端前肽(PⅠNP)、β-胶原降解产物(β-CTX)水平均低于治疗前,且地舒单抗组均低于常规组,差异均有统计学意义(P<0.05);治疗6、12个月后,两组25羟基维生素D(25-OH-VD)水平均显著高于治疗前,差异有统计学意义(P<0.05),但两组间比较,差异无统计学意义(P>0.05)。治疗前后,两组甲状旁腺素(PTH)水平比较,差异均无统计学意义(P>0.05);治疗6、12个月后,两组磷(P)水平、视觉模拟评分法(VAS)评分均显著低于治疗前,且地舒单抗组均显著低于常规组;治疗6个月后,两组钙(Ca)水平均低于治疗前,地舒单抗组低于常规组,治疗12个月后,地舒单抗组Ca水平高于常规组,差异均有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:地舒单抗注射液治疗PMO患者能有效提高临床效果,增加患者骨密度,改善骨钙磷代谢,缓解疼痛,且安全性良好。

Objective:To explore the effects of Denosumab Injection on bone density and bone metabolism in postmenopausal osteoporosis(PMO)patients.Method:A retrospective analysis was performed on 80 patients with PMO admitted to Nanchang Hongdu Hospital of TCM from January 2021 to October 2022.According to different medication methods,they were divided into Denosumab group(receiving Denosumab Injection on the basis of conventional treatment)and conventional group(conventional treatment),with 40 cases in each group.Clinical efficacy,bone density,bone metabolism,calcium and phosphorus metabolism,pain degree and occurrence of adverse reactions were analyzed in the two groups.Result:The total effect rate of Denosumab group was significantly higher than that of conventional group,the difference was statistically significant(P<0.05).After 6 and 12 months of treatment,lumbar vertebra bone density and femoral neck bone density in two groups were significantly higher than those before treatment,and those in Denosumab group were significantly higher than those in conventional group,the differences were statistically significant(P<0.05).After 6 and 12 months of treatment,the levels of typeⅠcollagen amino terminal propeptide(PⅠNP)andβ-CTX in two groups were lower than those before treatment,and those in Denosumab group were lower than those in conventional group,the differences were statistically significant(P<0.05).After 6 and 12 months of treatment,the levels of 25-hydroxyvitamin D(25-OH-VD)in two groups were significantly higher than that before treatment,the differences were statistically significant(P<0.05),but there were no statistical significance between two groups(P>0.05).Before and after treatment,there were no significant differences in the level of parathyroid hormone(PTH)between the two groups(P>0.05).After 6 and 12 months of treatment,the two phosphorus(P)level and visual analogue scale(VAS)score were significantly lower than those before treatment,and the Denosumab group was significantly lower than those in the conventional group,the differences were statistically significant(P<0.05).After 6 months of treatment,the calcium(Ca)levels in both groups were lower than that before treatment,that in the Denosumab group was lower than that in the conventional group;after 12 months of treatment,the Ca level in the Denosumab group was higher than that in the conventional group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Applying Denosumab Injection in the treatment of PMO patients can effectively improve clinical efficacy,increase bone density,improve bone calcium and phosphorus metabolism,relieve pain,and has good safety.