摘要
目的:探讨唑来膦酸联合经皮椎体后凸成形术(PKP)治疗老年椎体压缩性骨折的疗效及对患者骨密度、骨代谢的影响。方法:70例老年压缩性骨折患者随机分为观察组和对照组。两组患者均接受PKP,观察组术后第3天静滴唑来膦酸注射液5 mg。分别在术前、术后24 h、术后6个月、术后12个月评定两组患者视觉模拟疼痛评分(VAS)及Oswestry功能障碍指数评分(ODI);术前与术后12个月检测患者骨密度及骨特异性碱性磷酸酶(BAP)和I型前胶原肽(CTX);观察两组药品不良反应发生情况。结果:术后24 h、6个月及12个月两组患者VAS与ODI评分均较术前明显改善(P<0.05或P<0.01),且观察组患者评分明显低于对照组(P<0.05)。术后12个月,观察组患者骨密度较术前显著改善(P<0.05),血清BAP和CTX较术前明显下降(P<0.05),且均明显优于对照组(P<0.05);而对照组治疗前后上述指标无明显变化(P>0.05)。两组药品不良反应发生率比较,差异无统计学意义(P>0.05)。结论:唑来膦酸联合PKP治疗老年椎体压缩性骨折疗效较好,能增加患者骨密度,降低血清BAP和CTX水平,安全性好。
Objective： To discuss curative effect of zoledronic acid combined with percutaneous kyphoplasty（ PKP） on vertebral compression fractures（ VCF） in elderly patients and its influence on bone density and bone metabolism. Methods： 70 cases of elderly patients with VCF were divided into observation group and control group at random. The patients in two groups were given PKP,while the patients in observation group were additionally given 5mg zoledronic acid by intravenous drip on the third day after operation. The visual analogue scale（ VAS） and Oswestry disability index score（ ODI） were made before the operation,and 24 hours,6 months and 12 months after the operation,as well as bone density with bone specific alkaline phosphatase（ BAP） and type I Pro collagen peptide（ CTX） before and 12 months after the operation. The curative effect and bone density with bone metabolism of patients in two groups were compared,and the adverse drug reaction were observed as well. Results： The VAS and ODI scores of patients in two groups 24 hours,6 months and 12 months after the operation were all improved than before（ P〈0. 05 or P〈0. 01）,and the scores of patients in observation group was much lower than those in control group（ P〈0. 05）. At 12 months postoperatively,bone density of patients in observation group was improved than before（ P〈0. 05）,the serum BAP and CTX compared with the preoperative decreased significantly（ P〈0. 05）,and all index were better than control group（ P〈0. 05）; while there were no significant changes appeared on patients in control group before and after treatment（ P〉0. 05）. While campared the incidence of adverse drug reaction in two groups,the differance had no statistical significance（ P〉0. 05）. Conclusion： The application of zoledronic acid combined with PKP had favorable curative effect on VCF in elderly patients,and could improve bone density,reduce the serum level of BAP and CTX,it had good safety.
出处
《药物流行病学杂志》
CAS
2016年第5期281-284,共4页
Chinese Journal of Pharmacoepidemiology
关键词
椎体压缩性骨折
老年患者
经皮椎体后凸成形术
唑来膦酸
骨密度
骨代谢
Vertebral compression fractures
Elderly patients
Percutaneous kyphoplasty
Zoledronic acid
Bone density
Bone metabolism
