唑来膦酸注射液治疗绝经后女性骨质疏松症不良反应的观察  

Adverse Reactions to Zoledronic Acid Injection in Postmenopausal Women with Osteoporosis

作　　者：周淑兰[1] 章志玲[1] 梅志亮[1] 

机构地区：[1]江西省人民医院老年病科,南昌330006

出　　处：《实用临床医学（江西）》2015年第1期10-12,共3页Practical Clinical Medicine

摘　　要：目的观察唑来膦酸注射液治疗绝经后女性原发性骨质疏松症伴或不伴自发性骨折的临床不良反应。方法选取2013年1—12月在江西省人民医院住院治疗的绝经后女性骨质疏松症患者60例,所有患者均检测血钙、血磷正常,肌酐清除率（Ccr）〉35mL·min^-1,补充足够的钙剂、维生素D3或活性维生素D,静脉滴注唑来膦酸注射液5mg,给药前静脉或口服补水500～1 000mL,滴注唑来膦酸注射液时间必须〉15min,其中39例患者滴注唑来膦酸注射液前约1h使用了解热镇痛药（布洛芬胶囊）,21例患者滴注唑来膦酸注射液前未使用解热镇痛药。观察患者滴注唑来膦酸注射液后1个月内不良事件（发热、肌肉及关节疼痛）的发生情况。结果 39例在使用唑来膦酸注射液前1h,预防性使用解热镇痛药的患者,使用唑来膦酸后出现低热10例,中热3例,肌肉及关节疼痛的15例,无症状的11例。21例在使用唑来膦酸前未预防性使用解热镇痛药的患者,使用唑来膦酸后出现低热的6例,中热2例,肌肉及关节疼痛的3例,一过性肾功能损害1例,无症状9例。2组患者均未出现高热,发生一过性血肌酐升高的患者1例,经静脉补水治疗后1个月血肌酐恢复正常。结论在绝经后女性原发性骨质疏松症伴或不伴自发性骨折时,在补充足够活性钙剂及维生素D3或活性维生素D后,使用唑来膦酸注射液不良反应较轻;发热及骨骼肌疼痛等不良反应可用解热镇痛药预防或缓解。Objective To observe the adverse reactions to zoledronic acid injection in postmenopausal osteoporosis women with or without spontaneous fractures.Methods Sixty postmenopausal women with osteoporosis were treated in Jiangxi Provincial People＇s Hospital between January 2013 and December 2013.All patients had normal blood calcium and phosphorus levels with creatinine clearance rate 〉35mL·min^-1,and received enough calcium and vitamin D3 or active vitamin D supplements and intravenous zoledronic acid infusion（5mg）for longer than 15 minutes.Before administration,patients were given intravenous or oral rehydration（500-1 000 Ml）.Among the 60 patients,39took analgesic-antipyretic drugs（ibuprofen capsules）and 21 received no drugs 1hour before intravenous infusion of zoledronic acid.The incidence of adverse events（fever and muscle/joint pain）was observed within 1month after zoledronic acid treatment.Results Among the 39 patients who took analgesic-antipyretic drugs before zoledronic acid treatment,10 had mild fever,3had moderate fever,15 had muscle/joint pain and 9had no symptoms after zoledronic acid treatment.Among the 21 patients who received no drugs before zoledronic acid treatment,6had mild fever,2had moderate fever,3had muscle/joint pain,1had transient renal damage and 9had no symptoms after zoledronic acid treatment.No patients had severe fever in both groups.One patient had transient increase in serum creatinine,which restored to normal 1month after intravenous rehydration.Conclusion Enough active calcium and vitamin D3 or active vitamin D supplements can reduce the adverse reactions to zoledronic acid injection and analgesic-antipyretic drugs can prevent or alleviate the fever and skeletal muscle pain in postmenopausal osteoporosis women with or without spontaneous fractures.

关 键 词：骨质疏松症 绝经后女性 唑来膦酸注射液 

分 类 号：R681[医药卫生—骨科学] R173.4[医药卫生—外科学]