摘要
目的观察唑来膦酸注射液(密固达)防治全髋关节置换术后假体柄周围骨丢失的近期临床疗效。方法 2012年5月-2012年6月接受单侧全髋关节置换术患者,共20例,随机分为唑来膦酸组(观察组)和对照组。观察组术后1周接受唑来膦酸注射液静脉滴注,5 mg/次,共1次;对照组不接受唑来膦酸注射液治疗。术前、术后1年分别运用双能X骨密度仪测量股骨柄周围骨密度,分析骨量变化情况。结果共入选20例患者,两组各10例,随访1年;术后1年两组股骨假体周围平均骨密度均有所下降,I区和VII区下降显著,观察组IV区骨密度增高趋势。观察组股骨侧骨密度由术前平均1.523±0.325降至1.463±0.376,对照组由平均1.579±0.286降至1.295±0.357。术后3天两组钙、磷水平较术前稍下降,1年后均维持在术前水平。两组术后短期内ALP稍有所下降,与术前水平比较无显著差异;术后1年,对照组ALP恢复术前水平,观察组ALP处于较低水平,与术前及对照组比较具有显著差异。观察组用药后2-3天内有8例患者出现不同程度发热或肌肉酸痛,经服用乙酰氨基酚(泰诺林)缓解。结论唑来膦酸注射液可有效预防全髋关节置换术后早期假体柄周围骨量丢失,具有良好的依从性,但存在流感样副作用,术后1周内难以与手术相关发热相鉴别,故建议手术1周后,待全身情况稳定后使用,出现发热等症状时,给予乙酰氨基酚等消炎止痛类药物可缓解,未见其他不良反应。
Objective To observe the short-term clinical efficacy of zoledronic acid injection （Aclasta） on preventing periprosthetic bone loss around the femoral stem after the total hip arthroplasty. Methods Twenty patients, who underwentthe unilateral total hip arthroplasty from May 2012 to June 2012, were included and randomly divided into zoledronic acid group （observation group） and control group. One week after the operation, patients in the observation group received one intravenous injection of 5 mg zoledronic acid （Aclasta） , while patients in the control group did not receive the injection. The bone mineral density （BMD） around the femoral stem was detected using dual-energy X-ray absorptiometry preoperatively and 1-year after the operation. The results were used to analyze the bone mass change. Results A total of 20 patients were included, and each group contained 10 patients. The followed-up lasted for 1 year. The mean BMD around the femoral stem in both groups decreased 1-year after the operation, especially at Zone I and VII. But in the observation group, BMD at Zone IV showed a trend of increase. The mean BMD in the observation group decreased from preoperative 1. 523 ＋ 0. 325 to postoperative 1. 463 ± 0. 376, while the decrease was from preoperative 1. 579 - 0. 286 to postoperativel. 295 - 0. 357 in the control group. Compared to the preoperative level, the serum levels of calcium and phosphorus decreased slightly 3-day after the operation. But it maintained at the preoperative level 1- year after the operation. The serum ALP level in both groups declined slightly at early stage after the operation. One year later, the serum ALP in the control group returned to preoperative level, while the serum level in the observation group was lower than the preoperative level, and the difference between two groups was significant. Within 2 - 3 days after the injection, 8 patients in the observation group had varying degree of fever or muscle ache, which relieved after taking acetaminophen （Tylenol�
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2014年第7期795-799,共5页
Chinese Journal of Osteoporosis
关键词
唑来膦酸
全髋关节置换术
骨密度
骨丢失
Zoledronic acid injection （Aclasta）
Total hip arthroplasty
Bone mineral density （BMD）
Bone loss
