唑来膦酸对骨质疏松性骨折患者术后骨密度及再骨折的影响

Effect of Zoledronic Acid on Postoperative Bone Mineral Density and Refractures in Patients with Osteoporotic Fractures

目的:观察唑来膦酸对骨质疏松性骨折患者术后骨密度及再骨折的影响。方法:选取2017年4月—2018年4月我院收治的骨质疏松性骨折患者92例为研究对象,按照随机双盲法分为两组,各46例。两组均行经皮椎体成形术或经皮椎体后凸成形术,对照组术后给予常规治疗,在此基础上,观察组给予唑来膦酸注射液(5 mg注入0.9%氯化钠注射液10 mL中,静脉滴注,每间隔1个月注射1次)治疗。比较两组疼痛、骨密度、血清指标及再复发率。结果:观察组治疗3个月、6个月、12个月后视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P <0.05);治疗后,两组股骨大转子、股骨颈骨密度均高于治疗前,I型前胶原氨基端前肽(PINP)及I型胶原羧基端肽β特殊序列(β-CTX)水平均低于治疗前,且观察组改善更加显著,差异有统计学意义(P <0.05);观察组再骨折率低于对照组,差异有统计学意义(P <0.05)。结论:骨质疏松性骨折患者术后给予唑来膦酸治疗可有效促进骨形成,提高骨密度,减轻疼痛,加快骨折愈合,降低术后再骨折发生率。

Objective:To observe the effect of zoledronic acid on postoperative bone mineral density and re-fractures in patients with osteoporotic fractures.Methods:92 patients with osteoporotic fractures admitted to our hospital from April 2017 to April 2018 were selected as subjects investigated,and they were divided into two groups according to the random double-blind method,46 cases each.The patients in the two groups underwent percutaneous vertebroplasty or percutaneous kyphoplasty.The patients in the control group received routine treatment after surgery.On this basis,the patients in the observation group were given zoledronic acid injection(5 mg zoledronic acid injection was injected into 0.9%sodium chloride injection 10 mL,intravenous drip,once every 1 month).The pain,bone mineral density,serum index and recurrence rate were compared between the two groups.Results:The visual analog scale(VAS)scores in the observation group were lower than those in the control group after 3 months,6 months and 12 months of treatment,with statistically significant differences(P<0.05).The bone mineral density of the greater trochanters and necks of femurs after treatment were higher than those before treatment in the two groups,while the levels of PINP and I collagen carboxyl terminal peptide beta special sequence(beta-CTX)were lower than those before treatment,and the improvement in the observation group was more obvious,with statistically significant differences(P<0.05).The re-fracture rate in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Postoperative administration of zoledronic acid in the patients with osteoporotic fractures can effectively promote bone formation,increase bone mineral density,reduce pain,accelerate fracture healing and reduce the incidence of postoperative re-fractures.