唑来膦酸在骨质疏松骨折术后应用的临床疗效分析

Efficacy of zoledronic acid in patients after osteoporotic fracture operation

目的评价骨质疏松骨折术后应用唑来膦酸的临床疗效。方法选取2012年1月至2014年2月本组收治的骨质疏松骨折患者30例,其中女24例,男6例;年龄53~80岁,平均(67.6±8.1)岁。所有患者均予手术治疗,术后给予唑来膦酸注射液5 mg静脉滴注,其中术后5~7 d应用5例,术后1个月25例。术后12、24、36个月复查并记录骨密度变化,同时观察骨折愈合情况,记录治疗期间的症状和不良发应。结果本组患者治疗1年后骨密度均有所提高,且差异有统计学意义(P<0.05),连续应用3年骨密度持续提高,差异有统计学意义(P<0.05)。首次给予唑来膦酸治疗后,均出现不同程度的发热、乏力、头痛、关节痛、恶心等反应,再次应用不良反应明显减少(P<0.05)。无骨折不愈合、骨不连、术后内固定松动、断裂,螺钉退出等并发症发生。无再骨折发生。结论骨质疏松骨折术后应用唑来膦酸可以有效降低再骨折率、提高骨密度,且并不影响骨折愈合。

Objective To evaluate the efficacy of zoledronic acid in patients after osteoporotic fracture operation.Methods A total of 30 patients with osteoporotic fracture hospitalized from Jan.2012 to Feb.2014 were enrolled in this study, including 24 females and 6 males, aged from 53 to 80 years (67.6 ±8.1 on average).All the patients were given 5 mg zoledronic acid injection through intravenous drip after the operation; five patients were treated for 5 -7 days and 25 patients were treated for one month.The changes of the bone mineral density ( BMD) were reviewed and recorded respectively at 12 months, 24 months and 36 months after the operation.Fracture healing, symptoms and adverse reactions were recorded during the treatment.Results After one-year treatment, the BMD of the patients increased and the difference was statistically significant (P<0.05).The BMD continuously improved when the drug was continually given for three years and the difference was statistically significant ( P<0.05 ) .All the patients developed different extent of adverse reaction, including fever, fatigue, headache, joint pain and nausea after the first infusion of zoledronic acid.The adverse reactions significantly reduced since the second infusion ( P<0.05) .No complication was observed such as fracture, bone nonunion, postoperative internal fixation loosening and rupture, or screw exiting; no new osteoporotic fracture was observed. Conclusion The application of zoledronic acid after osteoporotic fracture operation can effectively reduce new osteoporotic fracture rate, increase BMD, and does not affect the fracture healing.