绝经期女性髋关节置换术后应用唑来膦酸对股骨假体周围骨密度及PICP、β-CTX、ALP、BALP水平的影响  

Effect of zoledronic acid on periprosthetic bone mineral density and levels of PICP,β-CTX,ALP and BALP in postmenopausal women after hip replacement

作　　者：叶征[1] 陈舰[1] 缪佳庆[1] YE Zheng;CHEN Jian;MIAO Jia-qing(Department of Orthopedics,Shanghai Putuo District People's Hospital,Shanghai 200060,China)

机构地区：[1]上海市普陀区人民医院骨科,上海200060

出　　处：《临床和实验医学杂志》2021年第19期2085-2089,共5页Journal of Clinical and Experimental Medicine

基　　金：上海市卫生和计划生育委员会科研课题(编号:201740150)。

摘　　要：目的探讨绝经期女性髋关节置换术后应用唑来膦酸治疗效果及对股骨假体周围骨密度及Ⅰ型前胶原羧基端肽(PICP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、碱性磷酸酶(ALP)、骨碱性磷酸酶(BALP)等的影响。方法回顾性选取2018年1月至2019年1月在上海市普陀区人民医院行髋关节置换术绝经期女性88例,根据患者住院号末尾奇偶数分为观察组(n=45)和对照组(n=43),对照组给予髋关节置换术,观察组在对照组基础上给予唑来膦酸治疗。观察2组治疗前后Harris评分、生活质量等,比较血清PICP、β-CTX、ALP、BALP及骨密度等差异。结果观察组治疗后6个月Harris评分为(82.26±6.15)分,明显高于对照组[(73.35±7.04)分],差异有统计学意义(P<0.05)。观察组治疗后6个月假体周围和腰椎骨密度分别为(0.67±0.20)、(181.16±26.65)g/cm 3,明显高于对照组[(0.50±0.18)、(0.47±0.06)g/cm 3],差异均有统计学意义(P<0.05)。观察组治疗后1个月血清PICP和ALP分别为(615.70±80.55)ng/mL和(181.16±26.65)U/L,明显高于对照组[(580.87±76.69)ng/mL、(165.54±24.40)U/L],而β-CTX和BALP分别为(0.58±0.10)、(15.56±2.29)μg/L,明显低于对照组[(0.92±0.14)、(20.15±3.35)μg/L],差异均有统计学意义(P<0.05)。观察组治疗后6个月SF-36量表各维度评分明显高于对照组,差异均有统计学意义(P<0.05)。观察组治疗后6个月WHOQOL-BREF评分为(79.65±8.03)分,明显高于对照组[(72.29±7.84)分],差异有统计学意义(P<0.05)。结论绝经期女性髋关节置换术后应用唑来膦酸治疗有较好的效果,提高患者骨密度,改善骨代谢及生活质量。Objective To investigate the therapeutic effect of zoledronic acid after hip replacement in menopausal women and its effect on periprosthesis bone mineral density,type I procollagen carboxy-terminal peptide(PICP),typeⅠcollagen carboxy-terminal peptideβspecial sequence(β-CTX),alkaline phosphatase(ALP)and bone alkaline phosphatase(BALP)were detected.Methods A total of 88 menopausal women undergoing hip replacement in Shanghai Putuo District People's hospital from January 2018 to January 2019 were selected,the patients were divided into observation group(n=45)and control group(n=43)according to the odd even number at the end of the admission number,the control group received hip replacement,the observation group was given zoledronic acid on the basis of control group,the Harris score and quality of life were observed before and after treatment,the serum PICP,β-CTX,ALP,BALP and BMD and so on were compared.Results The Harris score in observation group were(82.26±6.15)points,which were significantly higher than those in control group[(73.35±7.04)points],the differences were statistically significant(P<0.05).At 6 months after treatment,the bone density around the prosthesis and the lumbar vertebra in the observation group were(0.67±0.20)g/cm 3 and(181.16±26.65)g/cm 3,respectively,which were significantly higher than those in the control group[(0.50±0.18),(0.47±0.06)g/cm 3],the differences were statistically significant(P<0.05).At 1 months after treatment,serum PICP and ALP in observation group were(615.70±80.55)ng/mL and(181.16±26.65)U/L,which were significantly higher than those in control group[(580.87±76.69)ng/mL,(165.54±24.40)U/L],β-CTX and BALP were(0.58±0.10)μg/L and(15.56±2.29)μg/L,respectively,which were significantly lower than those in the control group[(0.92±0.14),(20.15±3.35)μg/L],the differences were statistically significant(P<0.05);The scores of each dimension of SF-36 in the observation group were significantly higher than those in the control group at 6 months after treatment,the

关 键 词：绝经期 髋关节置换术 唑来膦酸 治疗效果 骨密度 骨代谢 

分 类 号：R687.4[医药卫生—骨科学]