唑来膦酸辅助经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折疗效评价  

Clinical effect of zoledronic acid aided percutaneous kyphoplasty in the treatment of the vertebral body osteoporotic vertebral compression fractures

作　　者：占道禄[1] 林明侠[1] 林庆彪[1] 陈建[1] 戴晓华[1] 

机构地区：[1]海南省人民医院脊柱外科,海南海口570311

出　　处：《海南医学》2017年第17期2792-2795,共4页Hainan Medical Journal

摘　　要：目的评价唑来膦酸辅助经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折患者的临床效果。方法选取2013年12月至2016年3月海南省人民医院脊柱外科收治的84例骨质疏松性椎体压缩性骨折行经皮椎体后凸成形手术治疗的患者为观察对象,以简单随机化分组法分为观察组和对照组,每组42例。观察组在术后3 d予以静滴唑来膦酸针,对照组术后给予鲑鱼降钙素治疗。两组患者自入院起均予以口服碳酸钙/维生素D3片,600 mg/d。分别于术前及术后6个月、12个月行视觉模拟评分(VAS)、腰椎骨密度、血清Ⅰ型前胶原氨基端前肽(PⅠNP)及Ⅰ型胶原羧基端肽特殊序列(β-CTX)浓度检查,并进行统计分析。结果术后随访12个月,观察组患者的VAS评分为(1.53±0.24)分,明显低于对照组的(2.16±0.36)分,差异有统计学意义(P<0.05);观察组患者的腰椎骨密度为(0.579±0.048)g/cm2,明显高于对照组的(0.489±0.052)g/cm2,差异有统计学意义(P<0.05);观察组患者6个月、12个月的血清PⅠNP浓度分别为(14.22±2.15)ng/m L,(16.52±1.86)ng/m L,明显低于对照组的(22.17±1.46)ng/m L、(20.82±2.03)ng/m L,差异均有统计学意义(P<0.05);观察组患者6个月、12个月的β-CTX浓度分别为(0.18±0.03)ng/m L、(0.22±0.02)ng/m L,明显低于对照组的(0.31±0.02)ng/m L、(0.30±0.01)ng/m L,差异均有统计学意义(P<0.05)。且观察组患者的治疗依从性较好,新发椎体骨折少。结论骨质疏松性椎体压缩骨折患者在经皮椎体后凸成形术后应用唑来膦酸治疗可增加患者椎体骨密度、改善患者疼痛、预防新发椎体骨折,值得临床加以推广应用。Objective To evaluate the clinical effect of zoledronic acid aided percutaneous kyphoplasty in the treatment of patients with osteoporotic vertebral compression fractures. Methods A total of 84 patients with osteoporot-ic vertebral compression fractures, who admitted to Department of Spine Surgery in Hainan General Hospital from De-cember 2013 to March 2016 and treated with percutaneous kyphoplasty, were divided into the observation group and the control group in the light of simple randomization, with 42 patients in each group. The patients in the observation group were given intravenous zoledronic acid three days after surgery, and the patients in the control group were treat-ed with salmon calcitonin. The patients of two groups were given oral calcium carbonate/vitamin D3 tablets, 600 mg/d since admitted to our hospital. Visual analogue scale （VAS） score, lumbar vertebrae bone mineral density （BMD）, ami-no-terminal propeptide of typeⅠprocollagen （PⅠNP） andβ-isomerized C-terminal telopeptide of typeⅠcollagen （β-CTX-Ⅰ） concentrations were examined at 6 months and 12 months postoperatively, and those data were analyzed. Results After 12 months follow-up, the VAS score in the observation group was （1.53 ± 0.24）, which was significantly lower than （2.16±0.36） in the control group （P〈0.05）;the BMD in the observation group was （0.579±0.048） g/cm2, which was significantly higher than （0.489 ± 0.052） g/cm2 in the control group （P〈0.05）;the concentrations of serum PINP for 6 months and 12 months after therapy in the observation group were （14.22 ± 2.15） ng/mL and （16.52 ± 1.86） ng/mL, re-spectively, which were significantly lower than （22.17 ± 1.46） ng/mL and （20.82 ± 2.03） ng/mL in the control group （P〈0.05）;the concentrations ofβ-CTX-Ⅰfor 6 months and 12 months after therapy in the observation group were （0.18± 0.03） ng/mL and （0.22±0.02） ng/mL, which were significantly lower than （0.31±0.02） ng/mL and （0.30±0.01�

关 键 词：唑来膦酸 骨质疏松性椎体压缩骨折 经皮椎体后凸成形术 骨密度 

分 类 号：R683[医药卫生—骨科学]