老年骨质疏松症患者全髋关节置换后应用阿仑膦酸钠维D3  

Alendronate sodium/vitamin D3 for senile patients with osteoporosis after total hip arthroplasty

作　　者：黄飞麒[1,2] 赵晓[1] 姚乃捷[1] 陈燕梅[1] 

机构地区：[1]广东药科大学附属第一医院正骨科,广东省广州市510080 [2]广州中医药大学

出　　处：《中国组织工程研究》2017年第15期2303-2307,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81674000)~~

摘　　要：背景:老年骨质疏松症患者全髋关节置换相关的不良反应较为多见,尤其是假体周围骨密度降低造成的假体松动,甚至会导致翻修。目的:观察阿仑膦酸钠维D3在老年骨质疏松患者全髋关节置换后的临床疗效及安全性。方法:将老年骨质疏松患者74例随机分为研究组和对照组,每组37例。两组患者均行全髋关节置换,置换后一两周两组均接受钙剂治疗,研究组患者在此基础上给予阿仑膦酸钠维D3(70 mg)口服,每周1次,两组均连续规律用药6个月。结果与结论:(1)骨密度变化:治疗后3,6个月及1年,研究组腰椎及健侧髋部骨密度较治疗前均明显升高(P<0.05),且均明显高于对照组(P<0.05);(2)无菌性松动的发生率:两组间假体周围骨折及假体无菌性松动的发生率差异无显著性意义(P>0.05);(3)血肌酐、血磷及血钙水平:两组患者术前与治疗后3,6个月及1年的血肌酐、血磷及血钙水平均在正常范围内,组间及组内治疗前后对比均差异无显著性意义(P>0.05);(4)结果证实:阿仑膦酸钠维D3可有效增加老年骨质疏松患者全髋关节置换后的骨密度,且无明显不良反应,不影响肾功能及钙磷代谢。BACKGROUND： Adverse events following total hip arthroplasty are commonly seen in elderly osteoporotic patients,especially prosthetic loosening caused by reduced bone density surrounding the prosthesis, which even needs reversion.OBJECTIVE： To investigate the effectiveness and safety of alendronate sodium/vitamin D3 for total hip arthroplasty in elderly patients with osteoporosis.METHODS： Seventy-four patients with osteoporosis were randomized to experimental and control groups （n=37 per group）, and both received total hip arthroplasty, followed by the calcium supplementary treatment at 1-2 weeks.Meanwhile, the patients in the experimental group were orally given alendronate sodium/vitamin D3 （70 mg）, once weekly. The course was 6 months in both two groups.RESULTS AND CONCLUSION： In the experimental group, the bone mineral density of the lumbar vertebrae and contralateral hip were significantly increased at 3, 6 and 12 months postoperatively compared with baseline, and also significantly higher than those in the control group （P 〈 0.05）. （2） The incidence of aseptic loosening and prosthesis adjacent fracture did not differ significantly between two groups （P 〉 0.05）. （3） The serum levels of creatinine,phosphorus and calcium all kept in normal values at baseline and 3, 6 and 12 months postoperatively in both two groups,and showed no significant differences before and after treatment between two groups （P 〉 0.05）. （4） These findings indicate that alendronate sodium/vitamin D3 can effectively increase the bone mineral density of elderly osteoporotic patients after total hip arthroplasty free of significant adverse effects, and exposes no effect on renal function and calcium-phosphorus metabolism.

关 键 词：组织工程 髋关节 骨密度 骨科植入物 人工假体 全髋关节置换 骨质疏松症 阿仑膦酸钠维D3 假体松动 老年患者 假体周围骨折 血钙 血磷 血肌酐 国家自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]