鲑鱼降钙素在骨质疏松患者椎体压缩性骨折椎体成形术后的临床疗效  

Clinical Effect of Salmon Calcitonin in Patients with Osteoporosis after Vertebroplasty for Vertebral Compression Fractures

作　　者：金龙 张彤[1] 孙川江[1] 李萌[1] 

机构地区：[1]攀钢集团总医院骨科,四川攀枝花617000

出　　处：《医学综述》2017年第23期4781-4784,F0003,共5页Medical Recapitulate

摘　　要：目的探讨鲑鱼降钙素在骨质疏松患者椎体压缩性骨折椎体成形术后的临床疗效。方法选取2013年5月至2015年12月攀钢集团总医院收治的70例骨质疏松椎体压缩性骨折患者为研究对象,采用随机数字法分为观察组和对照组,各35例。所有患者均成功进行了椎体成形术。观察组患者给予肌内注射鲑鱼降钙素,术后3 d内,每日1次,每次20μg,之后改为每2日1次,每次10μg,连续使用1个月后间隔1个月,然后继续使用,整个疗程共6个月,治疗期间口服碳酸钙D_3片,每次600 mg,每日1次。对照组患者单纯口服碳酸钙D_3片,每次600 mg,每日1次,疗程6个月。观察并分析两组患者治疗前后的骨痛改善,腰椎及股骨颈骨密度,视觉模拟评分(VAS)和Barthel评分。结果观察组总有效率高于对照组[91.4%(32/35)比71.4%(25/35)](P<0.05)。治疗后,观察组腰椎和股骨颈骨密度分别为(0.86±0.14)g/cm^2、(0.88±0.15)g/cm^2,均高于对照组[(0.78±0.12)g/cm^2、(0.80±0.09)g/cm^2](P<0.05)。治疗后4周、12周和24周,两组患者VAS评分均呈下降趋势,且观察组VAS评分明显低于对照组;治疗后4周、12周和24周后,两组患者Barthel评分均呈升高趋势,且观察组Barthel评分高于对照组。两组VAS评分和Barthel评分组间、时点间、组间·时点间交互作用比较差异有统计学意义(P<0.01)。结论鲑鱼降钙素对缓解骨质疏松椎体压缩性骨折患者的疼痛效果显著,且患者术后恢复快,有利于患者术后正常生活。Objective To discuss and analyze the clinical effect of salmon calcitonin in patients with osteoperosis after vertebroplasty for vertebral compression fractures. Methods A total of 70 patients of osteoporotic vertebral compression fractures were randomly selected in Pangang Group General Hospital from May 2013 to Dec. 2015. They were randomly divided into an observation group（35 cases） and a control group （35 cases）by random number method. All patients were successfully treated with vertebroplasty. The patients in the observation group were given intramuscular injection of salmon calcitonin （3 days after operation,20 μg per time, once per day, then changed to once every 2 days, 10 μg each time, for one month continuously, then repeated after one month interval ,6 months as an entire course, during the treatment, oral calcium carbonate D3 ,600 mg per time, once per day was also taken）. The patients in the control group were treated with oral calcium carbonate D3 alone ,600 mg per time, once per day for 6 months. The improvement of bone pain, bone mineral density （BMD） of the lumbar vertebrae and femoral neck, visual analogue scale （VAS） and Barthel score were observed and analyzed before and after treatment. Results After treatment,the total effective rate was 91.43% in the observation group, which was significantly higher than that in the control group [ 91.4% （32/35） vs 71.4% （25/35） ] （P 〈 0. 05 ）. After treatment, the bone mineral density of lumbar vertebrae and femoral neck in the observation group were （0.86 -±0. 14） g/cm2, （0.88 ±0.15 ） g/cm2 ,higher than those of the control group[ （0.78 ± 0.12） g/cm2, （0.80 ± 0.09） g/cm2 ] （P 〈 0.05 ）. At 4 weeks, 12 weeks, and 24 weeks postoperatively, VAS scores and Barthel scores were improved in all patients. The improvement was significantly higher in the observation group than in the control group（ P 〈 0.05 ）. There were statistically significant differences in VAS score and Barthel score between gr

关 键 词：骨质疏松 椎体压缩性骨折 鲑鱼降钙素 椎体成形术 

分 类 号：R654.2[医药卫生—外科学]