首次注射唑来膦酸治疗骨质疏松症所致发热及相关因素分析  

Influencing factors for fever after the first use of zoledronic acid treatment for osteoporosis

作　　者：单慧亭[1] 陈春燕[1] 吉鹏[2] 李东锋[1] SHAN Hui-ting;CHEN Chun-yan;JI Peng;LI Dong-feng(Department of Pharmacology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054;Department of Rheumatology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054)

机构地区：[1]新疆医科大学第一附属医院药学部,乌鲁木齐830054 [2]新疆医科大学第一附属医院风湿免疫科,乌鲁木齐830054

出　　处：《中南药学》2021年第2期346-350,共5页Central South Pharmacy

基　　金：2016年新疆维吾尔自治区医院管理研究所、新医大一附院管理课题项目(No.2016GL10)。

摘　　要：目的探讨骨质疏松症患者首次使用唑来膦酸注射液发生发热的情况和影响因素。方法对某院2017年1月至2019年12月首次使用唑来膦酸注射液治疗骨质疏松症的155例住院患者进行回顾性分析,根据不良反应是否发生分为发生组及未发生组,比较患者年龄、性别、体质指数、民族、使用非甾体药物史、口服双膦酸盐史、口服使用激素、血清25羟维生素D水平、骨密度值、血钙水平等与发生不良反应的相关性,单因素和多因素Logistic回归分析发生急性期反应的影响因素。结果155例住院患者中50例(32.26%)出现发热反应;发生组与未发生组的性别、使用非甾体药物、双膦酸盐类药物口服治疗史、血清25羟维生素D水平比较差异有统计学意义(P<0.05)。Logistic回归分析显示使用非甾体药物(OR=0.084,P<0.05)、双膦酸盐类药物口服治疗史(OR=0.120,P<0.05)、血清25羟维生素D≥20 ng·mL-1(OR=0.976,P<0.05)是发热反应发生的保护性因素。结论骨质疏松症患者首次使用唑来膦酸注射液治疗发生发热反应较常见,长期使用非甾体药物、血清25羟维生素D≥20 ng·mL-1以及双膦酸盐类药物口服治疗史可减少发热反应发生的风险。Objective To determine the fever and influencing factors in patients with osteoporosis who used zoledronic acid injection for the first time.Methods Totally 155 hospitalized patients who used zoledronic acid injection to treat osteoporosis in January 2017 to December 2019 were retrospectively analyzed.According to the occurrence of adverse reactions,they were divided into acute phase reaction(APR)group and non-APR group.The information of the two groups,including age,gender,body mass index,ethnicity,history of using oral non-steroidal anti-inflammatory drugs(NSAIDs),history of taking oral bisphosphonates,oral use of hormones and serum 25-hydroxyvitamin D levels,bone mineral density and blood calcium levels,was used to analyze the correlation with adverse reactions.Single factor and multiple factors Logistic regression analysis the influencing factors of acute phase reaction.Results Among the 155 patients,50 patients experienced fever(32.26%).The differences between the APR group and the non-APR group were statistically different in gender,oral NSAID intake,oral bisphosphonate intake,and 25-hydroxyvitamin D levels(P<0.05).Logistic regression analysis showed that the use of NSAIDs(OR=0.084,P<0.05),oral bisphosphonate intake(OR=0.120,P<0.05),and 25 hydroxyvitamin D levels≥20 ng·mL-1(OR=0.976,P<0.05)were protective factors for the occurrence of acute reactions.Conclusion The incidence of fever induced by the first use of zoledronic acid is high.History of using oral NSAIDs,25-hydroxyvitamin D levels≥20 ng·mL-1,and oral bisphosphonate intake significantly reduces the risk of fever.

关 键 词：骨质疏松 唑来膦酸 发热 LOGISTIC回归分析 

分 类 号：R580[医药卫生—内分泌] R96[医药卫生—内科学]