骨化三醇联合唑来膦酸预防椎体成形术后临近椎体骨折的临床研究  

Clinical study of Calcitriol combined with Zoledronic Acid in the prevention of adjacent vertebral fracture after vertebroplasty

作　　者：孙敬华[1] 阮文礼[1] 王文辉[1] SUN Jing-hua;RUAN Wen-li;WANG Wen-hui(Department of Orthopaedics,Dalian Second People′s Hospital,Liaoning Province,Dalian 116011,China)

机构地区：[1]大连市第二人民医院骨科,辽宁大连116011

出　　处：《中国当代医药》2018年第9期49-52,共4页China Modern Medicine

摘　　要：目的探讨骨化三醇联合唑来膦酸预防椎体成形术(PKP)后临近椎体骨折的临床效果。方法选取2012年2月~2014年6月我院收治的256例胸腰椎压缩性骨折老年患者,PKP术后根据是否自愿应用骨化三醇联合唑来膦酸分为试验组(113例)和对照组(143例)。对照组给予单纯钙剂,试验组在给予钙剂、骨化三醇的基础上采用连续唑来膦酸治疗。所有患者分别于用药前后第3年进行骨密度、椎体高度、局部Cob角测量,并统计两组再骨折数量。结果试验组用药后第3年的骨密度>治疗前,差异有统计学意义(P<0.05)。试验组用药前后的椎体高度、Cob角比较,差异无统计学意义(P>0.05)。对照组用药前后骨密度比较,差异有统计学意义(P<0.05)。对照组用药后椎体高度低于用药前,Cob角>用药前,差异有统计学意义(P<0.05)。试验组用药后的骨密度、椎体高度>对照组用药后,Cob角<对照组用药后,差异有统计学意义(P<0.05)。试验组有1例患者出现临近椎体的骨折,对照组有11例出现临近椎体的骨折。结论持续足量应用骨化三醇联合唑来膦酸可以强化老年胸腰椎脆性骨折椎体后凸成形术后临近椎骨密度,预防其发生骨折,提高远期临床疗效。Objective To investigate the clinical effect of Calcitriol combined with Zoledronic Acid in the prevention of adjacent vertebral fracture after vertebroplasty.Methods From February 2012 to June 2014,256 elderly patients with thoracolumbar vertebral compression fracture were divided into experimental group(n=113)and control group(n=143)according to whether they were willing to use Calcitriol combined with Zoledronic Acid or not after PKP surgery.In the control group,only calcium supplement was used,while in the experimental group,on the basis of the control group,Calcitriol combined with continuous Zoledronic Acid was added.Bone mineral density(BMD),vertebral height,and local Cobb angle were measured before medication and the third year after medication in all patients.The number of refracture was calculated in the two groups.Results In the experimental group,the BMD in the third year after medication was significantly higher than that before treatment(P<0.05).There was no significant difference in the height of vertebral body or Cob angle before and after medication(P>0.05).The BMD of the control group before and after treatment was displayed a significant difference(P<0.05).The height of vertebral body in control group was shorter than that before medication,and the Cob angle was larger compared with prior treatment,which were in great differences(P<0.05).Compared with the control group after medication,the BMD was better and the vertebral height was larger in the experimental group after therapy,after medication,the Cob angle was small than that in the control group(P<0.05).In the experimental group,there was 1 case occurred with adjacent vertebral fracture,but 11 cases in the control group.Conclusion Combination of Calcitriol and Zoledronic Acid in continuous sufficient doses can strengthen the adjacent vertebral BMD in the elderly patients with brittle fracture of thoracolumbar spine after PKP surgery,prevent fracture,and improve the long-term clinical effect.

关 键 词：椎体成形术 骨化三醇 唑来膦酸 临近椎体 

分 类 号：R687.3[医药卫生—骨科学]