替勃龙对骨质疏松患者非骨水泥型人工全髋关节置换术后效果的影响  

Influence of tibolone on postoperative effect of osteoporosis patients with bone cementless type artificial total hip replacement

作　　者：樊飞[1] 王煜巍[1] 王志慧[2] Fan Fei Wang Yuwei Wang Zhihui(Department of Orthopedics, the Third People＇s Hospital of Datong , Datong , Shaaxi 037008, China （ Fan F, Wang YW Department of Endocrinology, the Third People ＇s Hospital of Datong , Datong , Shanxi 037008, China （ Wang ZH)

机构地区：[1]大同市第三人民医院骨科,山西省大同037008 [2]大同市第三人民医院内分泌科,山西省大同037008

出　　处：《中国基层医药》2017年第13期2022-2026,I0005,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨替勃龙对骨质疏松患者非骨水泥型人工全髋关节置换术后近远期疗效的影响.方法 选取行非骨水泥型人工全髋关节置换术的髋部骨折患者136例,依据骨质疏松发生情况分为疏松组和对照组,疏松组患者术后给予替勃龙治疗,随访12周,统计分析所有患者术中失血量、手术时间和血清骨碱性磷酸酶（bone alkaline phosphatase,sBAP）、骨钙素（osteocalcin,sOC）、Ⅰ型胶原交联C端肽（c-terminal peptide collagen cross-linking Ⅰ type,sCTx）,应用髋关节Harris评分评估髋关节功能,采用双能X线吸收法检测治疗前后腰椎骨密度（bone mineraL density,BMD）.结果 两组术中失血量、手术时间差异无统计意义（P〉0.05）;疏松组血清sBAP、sOC水平分别为（28.41±6.13）U/L、（22.74±5.87）μg/L,明显低于对照组[（35.18±7.21）U/L、（27.42±6.38）μg/L],血清sCTx水平为（0.56±0.21）ng/mL,高于对照组的（0.42±0.11）ng/mL,差异均有统计学意义（tsBAP=5.36,tsOC=6.62,tsCTx=6.71,P〈0.05）;疏松组髋关节功能优良率为58.82%,明显低于对照组的71.76%,差异有统计学意义（χ2=6.78,P〈0.05）;对照组12周内腰椎BMD高于疏松组,但差异无统计学意义（P〉0.05）.结论 非骨水泥型人工全髋关节置换术后骨质疏松患者骨代谢和骨密度均差于非骨质疏松患者,髋关节功能恢复较差,术后给予替勃龙抗骨质疏松治疗可有效避免骨量的进一步丢失,值得临床进一步推广.Objective To discuss the influence of tibolone on near and long-term postoperative effect of osteoporosis patients with bone cementless type artificial total hip replacement effect.Methods 136 patients with hip fracture by bone cementless type artificial total hip replacement were selected.According to the situation of osteoporosis,all patients were divided into osteoporosis group and control group.The osteoporosis group received tibolone treatment,followed up for 12 weeks.The intraoperative blood loss,operating time were analyzed.Enzyme-linked immunosorbent assay was used to determine serum bone alkaline phosphatase（sBAP）,osteocalcin（sOC）,C-terminal peptide collagen cross-linking Ⅰ type（sCTx）.Harris hip score was applicated to evaluate hip function.Before and after treatment,lumbar vertebra bone mineral density（BMD） was detected by dual-energy X-ray absorption metry method.Results The intraoperative blood loss,operating time between the two groups had no significant differences（all P〉0.05）.The serum sBAP and sOC levels of the osteoporosis group were （28.41±6.13）U/L,（22.74±5.87）g/L,which were significantly lower than those of the control group[（35.18±7.21） U/L,（27.42±6.38）g/L],the serum sCTx level[（0.56±0.21）ng/mL]was higher than that of the control group[（0.42±0.11）ng/mL].The differences were statistically significant（tsBAP=5.36,tsOC=6.62,tsCTx=6.71,all P〈0.05）.On behalf of the hip joint function in the osteoporosis group was 58.82%,which was lower than 71.76% in the control group（χ2=6.78,P〈0.05）.The lumbar spine BMD of the control group at 12 weeks was higher than the osteoporosis group,but there was no statistically significant difference（P〉0.05）.Conclusion The type of bone cement after total hip arthroplasty patients with osteoporosis bone metabolism and bone mineral density in osteoporosis patients are poor in the hip joint function recovery is poorer,postoperatively for drug resistance to osteoporosis treatment can effectively avoid fu

关 键 词：骨质疏松 非骨水泥型 人工全髋关节置换术 骨代谢 骨密度 替勃龙 

分 类 号：R687.4[医药卫生—骨科学]