摘要
目的:探讨唑来膦酸对老年骨质疏松性转子间骨折术后骨量丢失的影响。方法:将112例骨质疏松性转子间骨折老年患者分成两组,均口服钙剂及阿法骨化醇胶丸,研究组术前3~5 d再给予唑来膦酸钠5 mg滴注,监测两组术前与术后早期血清I型胶原氨基端前肽(P1NP)、β胶原降解产物(β-CTx)变化,骨折愈合及髋关节功能Harris评分。结果:两组术后血清P1NP均呈上升趋势,术后12周均达1.5倍术前水平(P>0.05);对照组术后8周β-CTx值达高峰,约3倍术前水平,研究组术后6周即达高峰,约2倍术前水平;术后12周对照组β-CTx仍高于术前水平约50%,研究组已接近术前水平。对照组、研究组骨折正常愈合率分别为91.7%、92.3%,两组间无差异(P>0.05);术后6个月研究组髋关节Harris评分为78.02±8.54,对照组为69.31±10.55(P<0.01)。结论:术前应用唑来膦酸钠可显著抑制术后早期骨质吸收速度,预防骨量丢失,改善髋关节功能,且不影响骨折愈合。
Objective To explore the effect of zoledronic acid on bone mass loss after elderly osteoporotic intertrochanteric fracture operation. Methods The patients with osteoporotie intertrochartteric fracture （112 cases） were divided into two groups, which were both orally given Calcium and Alfacalcidol Soft Capsules, and the patients in study group were given zoledronic acid （5 mg） from 3 to 5 d before surgery. The changes of serum P1 NP and β-CTx of the two groups were monitored before and after operation, and fracture healing and Harris hip scores were also detected. Results Postoperative serum P1NP showed an upward trend and was 1.5 times of preoperative level in both groups after 12 weeks of operation. The level of β -CTx in control group had reached its peak about 3 times of preoperative level after 8 weeks. The peak of β -CTx in control group was about 2 times of preoperative level after 6 weeks, and was still 50% higher than the preoperative level after 12 weeks, but the level of β -CTx in study group was close to preoperative level at this time point. The normal healing rates of fractures in control and study groups were 91.7% and 92.3 %, respectively. The Harris hip scores of study and control groups （78.02 ± 8.54 and 69.31 ± 10.55） showed a statistically significant difference （P〈0.01）. Conclusion Preoperative application of zoledronic acid can significantly inhibit the early bone absorption rate, prevent bone mass loss, improve the bone strength and function of hip joint, and do not affect the fracture healing.
作者
鲁秋东
张翠菊
LU Qiu-dong;ZHANG Cui-ju(Department of Spine and Joint Surgery,Wuqing Traditional Chinese Medicine Hospital,Tianjin（301700）,China)
出处
《中国中西医结合外科杂志》
CAS
2018年第5期573-577,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
关键词
唑来膦酸钠
骨质疏松
骨转换
转子间骨折
骨量丢失
Zoledronic acid
osteoporosis
bone turnover
intertrochanteric fracture
bone mass loss
