唑来膦酸对绝经后骨质疏松在疼痛和平衡能力方面的疗效分析  

The effect of Zoledronic acid on pain and balance in women with postmenopausal osteoporosis

作　　者：黄淑纾[1] 王军[1] 林华[2] HUANG Shushu WANG Jun LIN Hua(Department of Geriatrics, the Affiliated Hospital of Nantong University, Nantong 226001 Bone Disease Center,the Affiliated Drum Tower Hospital of Nanjing University Medical School)

机构地区：[1]南通大学附属医院老年科,南通226001 [2]南京大学医学院附属鼓楼医院骨病中心

出　　处：《南通大学学报（医学版）》2016年第5期390-394,共5页Journal of Nantong University(Medical sciences)

基　　金：江苏省社会发展基金资助项目(BE2011605)

摘　　要：目的:研究唑来膦酸(Zoledronic acid,ZOL)在改善骨质疏松患者骨密度(bone mineral density,BMD)的同时,能否缓解骨质疏松疼痛症状。观察ZOL联合钙和维生素D在治疗绝经后骨质疏松过程中对患者平衡能力的影响。方法:采用自身对比前瞻性试验的方法,选择2009年9月—2012年12月期间220例绝经后骨质疏松症妇女(平均年龄67岁),分别在基线、12个月时予单次输注ZOL 5 mg治疗,并分别在基线、12个月和24个月时测定BMD、疼痛评分[数字评分法(numerical rating scale,NRS)]和跌倒指数(fall index,FI)(每次使用ZOL前)。观测用药前后BMD、NRS和FI的变化,采用方差分析及最小显著差数方法(least significant difference,LSD)多重比较分别对其进行统计比较分析。结果:经过2年的5 mg ZOL治疗(1次/年),绝经后骨质疏松症患者腰椎和髋部的BMD呈连续显著升高,同时疼痛亦有持续缓解(P<0.05)。在治疗过程中每日口服元素钙和维生素D,FI也持续显著降低(P<0.05)。结论:绝经后骨质疏松症妇女连续2年使用每年1次ZOL 5 mg治疗,可以在增加BMD的同时减轻疼痛症状,还可以帮助改善平衡能力。Objective： To investigate whether there＇s any help r elieving the pain of osteoporosis as Zoledronic acid（ZOL）improving bone mineral density（BMD）. To observe the effect of ZOL accompanied by calcium and vitamin D on the balance ability in the course of treatment of postmenopausal osteoporosis. Methods： In this self-control, prospective trial, 220 postmenopausal women with osteoporosis（mean age 67 years） were to receive a single infusion of ZOL 5 mg at baseline and month 12. BMD, numerical rating scale（NRS） pain scores and fall index（FI） were measured at baseline, month 12 and 24（before each use of zoledronic acid）. The main outcome measures were the changes in lumbar spine and hip BMD, the changes in NRS pain scores and fall index. The ANOVA and least significant difference（LSD） multiple comparison was used for statistical comparison. Results： The patients with postmenopausal osteoporosis had significantly decreased NRS pain scores（P〈0.05） with significantly higher lumbar and hip BMD over 2 year treatment of once-yearly ZOL 5 mg. And FI was decreased（P〈0.05） with the oral daily elemental calcium and vitamin D in the treatment course. Conclusion： Zoledronic acid relieves pain with increased BMD over 2 years of treatment in women with postmenopausal osteoporosis. ZOL can help improve the balance ability.

关 键 词：骨质疏松症 唑来膦酸 骨密度 疼痛评分 跌倒指数 

分 类 号：R681[医药卫生—骨科学]