摘要
目的了解老年女性骨质疏松性骨折患者手术后应用双膦酸盐的临床反应,分析常见不良反应的相关特点。方法收集苏州大学附属第二医院骨科151例老年女性骨质疏松性骨折术后初次静脉应用双膦酸盐治疗病例,记录患者年龄、体质量、体质量指数(body mass index,BMI)、腰椎和股骨骨密度(bone mineral density,BMD)、肌酐清除率、Ⅰ型胶原C端肽交联(β-C-terminal peptide of typeⅠcollagen,β-CTX)、Ⅰ型原胶原N端前肽(procollagen typeⅠN-terminal prepeptide,P1NP)、术后用药时间、常见不良反应等数据;按患者不同年龄、体质量指数、骨密度分别分组,分析术后用药时间与不良反应发生的相关性;比较术后<2周内与术后≥2周用药时间与常见不良反应(发热、肌肉酸痛、腹泻、排尿困难、结膜充血、恶心、头晕和头痛)发生的相关性。结果在年龄分组中,80~89岁年龄段组术后用药时间(18.4±21.7)d与不良反应发生率(25%)的相关系数为-0.314,差异有统计学意义(P<0.05),其他各年龄组都提示术后用药时间与不良反应发生无相关性(P>0.05);在BMI、骨密度分组中,术后用药时间与不良反应发生无相关性(P>0.05);“术后<2周内应用组”与“术后≥2周应用组”之间,发热、肌肉酸痛、腹泻、排尿困难、结膜充血、恶心、头晕和头痛等不良反应发生率均差异无统计学意义(P>0.05)。结论80岁以上骨质疏松性骨折术后静脉应用双膦酸盐的时间间隔应适当延长;在骨科手术后静脉应用双膦酸盐时,早期应用(<2周)或晚期应用(≥2周)与常见不良反应发生无相关性。
Objective To understand the clinical responses of senile women patients with osteoporotic fractures to intravenous bisphosphonates administration after surgery,and to analyze the characteristics of common adverse reactions.Methods A total of 151 senile women patients with osteoporotic fractures who received intravenous zoledronic acid after surgeries were enrolled in this study.Their ages,body weights,body mass indexes(BMI),lumbar spine and femur bone mineral density(BMD),creatinine clearance rates,β-C-terminal peptide of typeⅠcollagen(β-CTX),procollagen typeⅠN-terminal prepeptide(P1NP),postoperative treatment time,common adverse reactions,and other data were recorded.They were divided into groups according to ages,body mass indexes,BMD,respectively,and analyzed the correlation between postoperative medicine administration time and adverse reactions(fever,muscle aches,diarrhea,dysuria,conjunctival hyperemia,nausea,dizziness,and headache)in“administration within 2 weeks after surgery”group and“administration over 2 weeks after surgery”group.Results Among the age groups,the correlation coefficient-0.314 between postoperative treatment time(18.4±21.7 day).and adverse reactions(25%)in the 80-89 year-old group was statistically significant(P<0.05).There was no significant correlation between“postoperative treatment time”and adverse reactions in other age groups(P>0.05).Among the groups divided by BMI and BMD,there was no correlation between postoperative treatment time and adverse reactions(P>0.05).There were no statistically significant differences between the“administration within 2 weeks after surgery”group and“administration over 2 weeks after surgery”group in adverse reactions such as fever,muscle aches,diarrhea,dysuria,conjunctival hyperemia,nausea,dizziness,and headache(P>0.05).Conclusions The intravenous application of bisphosphonates should be postponed after surgery in senile women over 80 years old with osteoporotic fractures.There was no statistically significant difference in ad
作者
宋宏晖
金佳
姜习凤
吴龙英
祁双
顾颀
贾鹏
陈香凤
徐又佳
SONG Hong-hui;JIN Jia;JIANG Xi-feng;WU Long-ying;QI Shuang;GU Qi;Jia Peng;CHEN Xiang-feng;XU You-jia(Department of Orthopedics,Second Affiliated Hospital of Soochow University,Suzhou 215004,Jiangsu,China;不详)
出处
《中华骨质疏松和骨矿盐疾病杂志》
CSCD
北大核心
2021年第1期23-28,共6页
Chinese Journal Of Osteoporosis And Bone Mineral Research
基金
国家自然科学基金青年项目(81874018,81803242)
江苏省临床医学重点(BE2019661)
姑苏卫生领军人才(GSWS2019004)
苏州民生科技项目(SS201814)
中国博士后基金面上项目(2017M621820)
苏州大学附属第二医院科教兴院青年人才(XKTJ-RC202012)。
关键词
骨质疏松性骨折
双膦酸盐
不良反应
osteoporotic fracture
bisphosphonates
adverse reactions
