唑来膦酸对原发性骨质疏松症患者骨密度、骨代谢及脆性骨折发生率的影响
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摘要
目的观察唑来膦酸对原发性骨质疏松症患者骨密度、骨代谢及脆性骨折发生率的影响。方法原发性骨质疏松患者150例随机分为实验组和对照组,每组各75例,对照组给予钙尔奇D片口服,1片/次,1次/d,连续12周;实验组在对照组基础上给予静脉滴注唑来膦酸,1次/d,连续4周,观察并比较两组患者治疗前后骨密度(BMD)、骨特异性碱性磷酸酶(BALP)、血清Ⅰ型胶原交联C端肽(β-CTX),临床治疗有效率及脆性骨折发生率。结果治疗后两组BMD水平高于治疗前,β-CTX、BALP水平低于治疗前(P<0. 05),实验组BMD水平高于对照组,β-CTX、BALP水平低于对照组(P<0. 05),实验组治疗总有效率高于对照组(χ~2=5.691,P<0. 05);实验组脆性骨折发生率低于对照组(χ~2=5.496,P<0. 05)。结论唑来膦酸能升高原发性骨质疏松症患者BMD水平,降低β-CTX、BALP水平以及脆性骨折发生率,临床疗效较好。
Objective To investigate the effect of Zoledronic acid on bone mineral density,bone metabolism and incidence rate of fragility fracture in patients with primary osteoporosis. Methods 150 patients with primary Osteoporosis were randomly divided into experimental group and control group( n = 75).The control group were treated with Caltrate D tablets( orally,1 tablet each time,1 time/d,for 12 weeks) and the experimental group was given intravenous infusion of Zoledronic acid( 1 time/d,for 1 month). The bone mineral density( BMD),bone-specific alkaline phosphatase( BALP) and serum type I collagen cross-linked C-terminal peptide( β-CTX),clinical treatment efficiency and incidence rate of fragility fracture were observed and compared before and after treatment. Results The levels of BMD in the two groups were higher than those before treatment,and the levels of β-CTX and BALP were lower than those before treatment( P<0.05).The BMD level in the experimental group was higher than that in the control group,and the levels of β-CTX and BALP were lower than those in the control group( P<0. 05).The total effective rate of the experimental group was higher than that of the control group( χ~2= 5. 691,P < 0.05).The incidence rate of fragility fracture in the experimental group was lower than that of the control group( χ~2= 5.496,P<0.05).Conclusion Zoledronic acid can increase the level of BMD in patients with primary Osteoporosis and reduce the level of β-CTX,BALP and incidence rate of fragility fractures. Its clinical effect has been better.
Objective To investigate the effect of Zoledronic acid on bone mineral density,bone metabolism and incidence rate of fragility fracture in patients with primary osteoporosis. Methods 150 patients with primary Osteoporosis were randomly divided into experimental group and control group( n = 75).The control group were treated with Caltrate D tablets( orally,1 tablet each time,1 time/d,for 12 weeks) and the experimental group was given intravenous infusion of Zoledronic acid( 1 time/d,for 1 month). The bone mineral density( BMD),bone-specific alkaline phosphatase( BALP) and serum type I collagen cross-linked C-terminal peptide( β-CTX),clinical treatment efficiency and incidence rate of fragility fracture were observed and compared before and after treatment. Results The levels of BMD in the two groups were higher than those before treatment,and the levels of β-CTX and BALP were lower than those before treatment( P<0.05).The BMD level in the experimental group was higher than that in the control group,and the levels of β-CTX and BALP were lower than those in the control group( P<0. 05).The total effective rate of the experimental group was higher than that of the control group( χ~2= 5. 691,P < 0.05).The incidence rate of fragility fracture in the experimental group was lower than that of the control group( χ~2= 5.496,P<0.05).Conclusion Zoledronic acid can increase the level of BMD in patients with primary Osteoporosis and reduce the level of β-CTX,BALP and incidence rate of fragility fractures. Its clinical effect has been better.
引文
[1]秦集斌,宋洁富,薛旭红.原发性骨质疏松症的病因学研究进展[J].中国骨质疏松杂志,2016,22(4):511-514.
[2]蔡瑞玉.中西医结合治疗原发性骨质疏松症临床观察[J].河北中医,2016,38(5):713-717.
[3]宋红,黄华,王伟,等.不同性别及年龄因素对原发性骨质疏松症骨代谢指标、血清骨保护素及骨密度影响的研究[J].中国骨质疏松杂志,2015,21(10):1 161-1 164.
[4]张晓茹,徐霖,吴立兵,等.99Tc-MDP联合骨化三醇治疗原发性骨质疏松症的疗效观察[J].北京医学,2016,38(3):250-252.
[5]张晓梅,刘忠厚.唑来膦酸盐与骨质疏松症[J].中国骨质疏松杂志,2009,15(11):857-863.
[6]黄志勇,谭志明,庄宇.唑来膦酸钠治疗骨质疏松症的效果评价(附60例)[J].航空航天医学杂志,2010,21(8):1 333-1 334.
[7] Nakamura T,Fukunaga M,Nakano T,et al.Efficacy and safety of once-yearly zoledronic acid in Japanese patients with primary osteoporosis:two-year results from a randomized placebo-controlled double-blind study(ZOledro Nate treatment in Efficacy to osteoporosis; ZONE study)[J].Osteoporosis International,2017,28(1):389-398.
[8]陶天遵,邱贵兴,朱汉民,等.原发性骨质疏松症的治疗与预防[J].中国骨与关节外科,2015,8(5):377-384.
[9]刘颖,马凤云.阿仑膦酸钠及唑来膦酸治疗原发性骨质疏松症患者的临床疗效研究[J].河北医学,2016,22(1):25-29.
[10]冯和林.椎体成形术联合唑来膦酸治疗老年COPD患者骨质疏松性胸椎压缩骨折的近期疗效分析[J].川北医学院学报,2015,30(4):458-461.
[11] Yan S,Zhang Y,Lu D,et al.ECM-receptor interaction as a prognostic indicator for clinical outcome of primary osteoporosis[J].International Journal Of Clinical And Experimental Medicine,2016,9(1):9-20.
[12]刘连勇,郑胜喜,甄燕,等.原发性骨质疏松症的骨骼免疫机制研究进展[J].中国骨质疏松杂志,2016,22(7):912-917.
[13]沈追孟.唑来膦酸对骨质疏松症的疗效及其对骨代谢指标的影响[J].中国生化药物杂志,2016,36(4):74-76.
[2]蔡瑞玉.中西医结合治疗原发性骨质疏松症临床观察[J].河北中医,2016,38(5):713-717.
[3]宋红,黄华,王伟,等.不同性别及年龄因素对原发性骨质疏松症骨代谢指标、血清骨保护素及骨密度影响的研究[J].中国骨质疏松杂志,2015,21(10):1 161-1 164.
[4]张晓茹,徐霖,吴立兵,等.99Tc-MDP联合骨化三醇治疗原发性骨质疏松症的疗效观察[J].北京医学,2016,38(3):250-252.
[5]张晓梅,刘忠厚.唑来膦酸盐与骨质疏松症[J].中国骨质疏松杂志,2009,15(11):857-863.
[6]黄志勇,谭志明,庄宇.唑来膦酸钠治疗骨质疏松症的效果评价(附60例)[J].航空航天医学杂志,2010,21(8):1 333-1 334.
[7] Nakamura T,Fukunaga M,Nakano T,et al.Efficacy and safety of once-yearly zoledronic acid in Japanese patients with primary osteoporosis:two-year results from a randomized placebo-controlled double-blind study(ZOledro Nate treatment in Efficacy to osteoporosis; ZONE study)[J].Osteoporosis International,2017,28(1):389-398.
[8]陶天遵,邱贵兴,朱汉民,等.原发性骨质疏松症的治疗与预防[J].中国骨与关节外科,2015,8(5):377-384.
[9]刘颖,马凤云.阿仑膦酸钠及唑来膦酸治疗原发性骨质疏松症患者的临床疗效研究[J].河北医学,2016,22(1):25-29.
[10]冯和林.椎体成形术联合唑来膦酸治疗老年COPD患者骨质疏松性胸椎压缩骨折的近期疗效分析[J].川北医学院学报,2015,30(4):458-461.
[11] Yan S,Zhang Y,Lu D,et al.ECM-receptor interaction as a prognostic indicator for clinical outcome of primary osteoporosis[J].International Journal Of Clinical And Experimental Medicine,2016,9(1):9-20.
[12]刘连勇,郑胜喜,甄燕,等.原发性骨质疏松症的骨骼免疫机制研究进展[J].中国骨质疏松杂志,2016,22(7):912-917.
[13]沈追孟.唑来膦酸对骨质疏松症的疗效及其对骨代谢指标的影响[J].中国生化药物杂志,2016,36(4):74-76.