鲑鱼降钙素联合唑来膦酸预防老年胸腰段骨质疏松性椎体压缩性骨折的临床疗效

Clinical Efficacy of Salmon Calcitonin Combined with Zoledronic Acid in the Prevention of Thoracolumbar Vertebral Osteoporotic Compression Fractures in the Elderly

目的 :观察鲑鱼降钙素联合唑来膦酸预防老年胸腰段骨质疏松性椎体压缩性骨折的临床疗效及对骨密度、血清骨特异性碱性磷酸酶(BAP)、I型前胶原肽(CTX)水平的影响。方法 :选取我院骨科2015年1月—2018年1月收治的老年胸腰段骨质疏松患者100例作为研究对象,按随机数字表法分为鲑鱼组与联合组,各50例。鲑鱼组给予鲑鱼降钙素肌注(50 U,im,qd),联合组在鲑鱼组基础上加用唑来膦酸(5 mg)。比较两组治疗前后视觉模拟疼痛评分(VAS)与功能障碍指数评分(ODI)、检测骨密度及BAP和CTX水平,统计不良反应,随访6个月记录复发情况。结果:两组治疗后VAS与ODI评分均降低,且联合组低于鲑鱼组,差异有统计学意义(P <0.05);两组治疗后骨密度较治疗前升高,BAP和CTX水平均较前下降,且联合组优于鲑鱼组,差异有统计学意义(P <0.05)。结论:鲑鱼降钙素联合唑来膦酸治疗老年骨折疏松的疗效显著,可增加患者的骨密度,降低BAP、CTX水平,减少胸腰段骨质疏松性的椎体压缩性骨折的发生,且安全性高,值得在临床应用及推广。

Objective:To observe the clinical efficacy of salmon calcitonin combined with zoledronic acid in the prevention of thoracolumbar vertebral osteoporotic compression fractures in the elderly and its effect on bone mineral density and serum bone specific alkaline phosphatase(BAP)and type I procollagen peptide(CTX)levels.Methods:100 elderly patients with thoracolumbar vertebral osteoporotic compression fractures admitted to our Department of Orthopedics from January 2015 to January 2018 were selected as subjects investigated and randomly divided into a salmon group and a combined group,50 cases each.The patients in the salmon group were given intramuscular injection of salmon calcitonin(50 U,im,qd),and the patients in the combined group were further given zoledronic acid(5 mg).The visual analogue pain scale(VAS)scores,Oswestry disability index(ODI)scores,bone mineral density and BAP and CTX levels before and after treatment were compared between the two groups.Adverse reactions were statistically analyzed.The recurrence was recorded after 6 months of follow-up.Results:The VAS and ODI scores in the two groups after treatment were decreased,and the scores in the combined group were lower than those in the salmon group,with statistically significant differences(P<0.05).The bone mineral density after treatment was higher than that before treatment in the two groups,while the levels of BAP and CTX after treatment were lower than those before treatment,and these indexes in the combined group were better than those in the salmon group,with statistically significant differences(P<0.05).Conclusion:Salmon calcitonin combined with zoledronic acid is significantly effective in the treatment of osteoporosis in elderly patients,which can increase bone mineral density,reduce BAP and CTX levels and reduce the incidence of thoracolumbar vertebral osteoporotic compression fractures,and is safe and worthy of clinical application and promotion.