摘要
目的观察阿仑膦酸钠联合髋关节置换术治疗老年股骨颈骨折的疗效及其对患者血清分泌型蛋白骨硬化蛋白(SOST)及胰岛素生长因子-1(IGF-1)水平的影响。方法2016年8月-2018年8月于宿迁市第一人民医院骨科住院治疗符合纳入标准的股骨颈骨折老年患者80例,按照随机数字表法分为对照组和观察组,各40例。对照组男性21例,女性19例,年龄65~86岁,平均76.4岁;观察组男性23例,女性17例,年龄65~88岁,平均77.0岁。对照组给予髋关节置换术,观察组在对照组的基础上给予每日10mg阿仑膦酸钠片(10mg/片,石药集团欧意药业有限公司,国药准字H10980109),口服药物治疗3个月。采用抗酒石酸酸性磷酸酶(TRAP)评价破骨细胞活性,Harris评分评价治疗有效率。比较两组患者疗效、骨密度、日常生活能力、SOST水平、IGF-1水平及并发症发生率。结果观察组治疗有效率为90.0%,高于对照组的62.5%(χ^2=8.350,P=0.004)。术前两组患者的骨密度、TRAP、日常生活能力、SOST及IGF-1水平差异无统计学意义(P>0.05)。术后3个月,观察组的TRAP、SOST水平低于对照组[(2.36±0.85)μg/L vs.(2.95±0.88)μg/L、(11.37±0.94)μg/mL vs.(13.45±1.26)μg/mL,P<0.05];观察组的IGF-1水平、日常生活能力、骨密度均高于对照组[(351.36±41.35)μg/L vs.(313.45±38.78)μg/L、(78.96±5.67)分vs.(67.85±4.93)分、(0.596±0.097)g/cm 2 vs.(0.432±0.059)g/cm 2,P<0.05]。两组内固定物松动率及下肢深静脉血栓发生率差异无统计学意义(P>0.05)。结论应用阿仑膦酸钠联合髋关节置换术治疗老年股骨颈骨折疗效显著,且可显著抑制患者体内钙的流失,防止骨质疏松,加速骨折修复,且内固定物松动率及下肢深静脉血栓发生率低。
Objective To observe the effect of alendronate combined with hip replacement in the treatment of femoral neck fracture in the elderly,and its influence on serum SOST and IGF-1 levels.Methods Eighty elderly patients with femoral neck fracture were treated in our hospital from Aug.2016 to Aug.2018.They were divided into control group and observation group according to random number table,with 40 cases in each group.There were 21 males and 19 females in the control group,aged 65-86 years,with an average age of 76.4 years;there were 23 males and 17 females in the observation group,aged 65-88 years,with an average age of 77.0 years.The control group was given hip replacement,while the observation group was given alendronate sodium tablets on the basis of the control group.The curative effect,bone mineral density,daily living ability,SOST level,IGF-1 level and the incidence of complications were compared between the two groups.Results The effective rate of the observation group was 90.0%,higher than 62.5%of the control group(χ^2=8.350,P=0.004).Before operation,there was no difference in bone mineral density,TRAP,daily living ability,SOST and IGF-1 levels between the two groups(P>0.05).After operation,the levels of TRAP and SOST in the observation group were lower than those in the control group(P<0.05);the levels of IGF-1,daily living ability and bone mineral density in the observation group were higher than those in the control group(P<0.05).There was no significant difference between the two groups in the rate of internal fixation loosening and the incidence of deep venous thrombosis(P>0.05).Conclusion Alendronate combined with hip arthroplasty has good clinical efficacy in the treatment of elderly femoral neck fracture,and can significantly inhibit the loss of calcium,inhibit osteoporosis,accelerate fracture repair,and have fewer complications.
作者
裴儒
何仁豪
尹识渊
PEI Ru;HE Ren-hao;YIN Shi-yuan(Department of Orthopedics,Suqian First People's Hospital,Suqian,Jiangsu 223800,China)
出处
《创伤外科杂志》
2020年第1期32-36,共5页
Journal of Traumatic Surgery
