阿仑磷酸钠联合阿法骨化醇治疗老年肱骨近端骨折的效果  

Efficacy of Alendronate combined with Alfacalcidol in the treatment of elderly patients with proximal humeral fracture

作　　者：朱超[1] 刘伟[1] 王华[1] 金刘琴 於青[3] 刘新晖[1] 

机构地区：[1]南京医科大学附属南京江宁医院骨科,江苏南京211100 [2]南京医科大学附属南京江宁医院放射科,江苏南京211100 [3]南京医科大学附属南京江宁医院检验科,江苏南京211100

出　　处：《中国医药导报》2016年第24期85-88,104,共5页China Medical Herald

基　　金：江苏省自然科学基金项目(BK20141436)

摘　　要：目的比较老年肱骨近端骨折术后联合应用阿仑磷酸钠及阿法骨化醇与单纯使用阿法骨化醇的疗效。方法选择2010年1月-2014年4月在南京医科大学大学附属南京江宁医院治疗的老年肱骨近端骨折患者60例为研究对象，采用随机数字表法将其分为治疗组及对照组，每组各30例。所有患者均采用肱骨近端锁定钢板治疗，治疗组术后口服阿仑磷酸钠1次／周，每次70mg，阿法骨化醇1次／d，每次0．5μg。对照组术后口服阿法骨化醇1次／d，每次0．5μg。所有患者均获得2年随访。观察骨折愈合情况，测量健侧腕部骨密度（BMD）、测定血清碱性磷酸酶（ALP）含量，采用Neer评分评价肩关节功能。结果所有患者均在术后1年内获得骨折愈合。术后6个月、1年、2年，治疗组患者骨密度高于对照组，差异均有高度统计学意义（P〈0．01）；术后6个月、1年、2年治疗组血清碱性磷酸酶均低于对照组，差异均有高度统计学意义（P〈0．01）。术后6个月、术后1年两组患者肩Neer评分比较，差异无统计学意义（P〉0．05）；术后2年，治疗者Neer评分优于对照组，差异有统计学意义（P〈0．05）。结论联合应用阿仑磷酸钠及阿法骨化醇不影响肱骨近端骨折愈合进程，并且能有效提升骨密度，改善术后肩关节功能。Objective To compare the effect of combined use of Alendronate and Alfacalcidol and simple use of Alfa- calcidol in elderly patients of proximal humeral fracture treated with proximal humeral locking plates. Methods Sixty geriatric patients of proximal humeral fracture from January 2010 to April 201d treated in the Jiangning Hospital Affiliated to Nanjing Medical University were selected as the study objects, they were divided into treatment group and con- trol group by random number table, with 30 cases in each group. All the patients were given the treatment of proximal humeral locking plates, patients in the treatment group were given Alendronate and Alfacalcidol （once a day, 50 μg each time） orally after operation. Patients in the control group were given simple Alfacalcidol （once a day, 50 μg each time） orally after operation. All patients were followed up for 2 years. The fracture healing and the bone mineral density （BMD） of health side wrist and the content of serum alkaline phosphatase （ALP） were evaluated. Neer score was applied to evaluate the function of the operated shoulder joint. Results All fractures were obtained bone union within one year. The BMD in the treatment group was significantly higher than that of the control group in 6 months, 1 year and 2 years after operation, the differences were statistically significant （P 〈 0.01）; the ALP in the treatment group was remarkably lower than that of the control group in 6 months, 1 year and 2 years after operation, the differences were statistically signif- icant （P 〈 0.01）. There was no significant difference about the function of the operated shoulder joint between two groups in 6 months and 1 year after operation. Neer score 6 months and 1 year after operation between two groups had no statistically significant difference （P 〉 0.05）; Neer score in treatment group was significantly higher than that in the control group in 2 years after operation, the difference was statistically significant （P 〈 0.05）. Conc

关 键 词：阿仑磷酸钠 阿法骨化醇 老年肱骨近端骨折 锁定钢板 骨密度 

分 类 号：R683.41[医药卫生—骨科学]