特立帕肽预防骨质疏松椎体压缩性骨折PVP术后再发骨折的临床研究  

CLINICAL EFFECT OF TERIPARATIDE IN PREVENTING RECURRENT FRACTURE AFTER PERCUTANEOUS VERTEBROPLASTY FOR OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURE

作　　者：郝锰 李君[1] 金沧海 栾晓娜[1] 栾舰[1] 历强[1] 孔猛 林勇[1] HAO Meng;LI Jun;JIN Canghai;LUAN Xiaona;LUAN Jian;LI Qiang;KONG Meng;LIN Yong(Department of Spinal Surgery, Qingdao Municipal Hospital, Qingdao 266071, China)

机构地区：[1]青岛市市立医院脊柱外二科,山东青岛266071

出　　处：《精准医学杂志》2021年第5期399-403,共5页Journal of Precision Medicine

基　　金：青岛市民生科技计划项目(19-6-1-17-nsh)。

摘　　要：目的分析12个月的特立帕肽治疗在预防骨质疏松椎体压缩性骨折(OVCF)椎体成形术(PVP)后再发骨折及提高患者生活质量方面的有效性。方法回顾性分析PVP术后接受特立帕肽治疗(99例)及唑来膦酸治疗(192例)的女性患者的临床资料,通过Logistic回归对每一年随访期内两组患者新发椎体骨折风险进行分析。使用重复测量设计资料的混合线性效应模型(LMMRM)对两组患者健康相关生活质量评分(EQ-5D)及腰背部疼痛视觉模拟(VAS)评分进行对比。结果Logistic回归校正基线资料后显示,特立帕肽组在第2~4年的随访期内新发骨折的风险明显低于唑来膦酸组(第2年,OR=0.149,95%CI=0.021~0.741,P<0.05;第3年,OR=0.011,95%CI=0.001~0.133,P<0.01;第4年,OR=0.017,95%CI=0.001~0.222,P<0.01)。经过LMMRM模型校正后显示,相对于唑来膦酸组,特立帕肽组患者的EQ-5D评分呈现上升的趋势,腰背部VAS评分呈现下降的趋势。结论12个月的特立帕肽皮下注射治疗可有效降低PVP术后患者再发骨折的风险,同时可明显提高患者的生活质量。Objective To investigate the clinical effect of 12 month-teriparatide(TPTD)treatment in preventing recurrent fracture and improving quality of life after percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fracture(OVCF).Methods A retrospective analysis was performed for the clinical data of 99 female patients receiving TPTD treatment after PVP and 192 female patients receiving zoledronic acid after PVP,and a logistic regression analysis was used to analyze the risk of new-onset vertebral compression fracture(NVCF)within the follow-up period each year.The linear mixed model for repeated measures(LMMRM)was used to compare European Quality of Life-5 Dimensions(EQ-5D)health-related quality of life score and Visual Analogue Scale(VAS)score of lower back pain between the two groups.Results The logistic regression analysis showed that after adjustment for baseline data,the TPTD group had a significantly lower risk of NVCF than the zoledronate group during follow-up in the second,third,and fourth years(second year:OR=0.149,95%CI=0.021-0.741,P<0.05;third year:OR=0.011,95%CI=0.001-0.133,P<0.01;fourth year:OR=0.017,95%CI=0.001-0.222,P<0.01).The LMMRM model showed that after adjustment,compared with the zoledronic acid group,the TPTD group had a tendency of increase in EQ-5D score and a tendency of reduction in VAS score of lower back pain.Conclusion For patients receiving PVP after OVCF,subcutaneous injection of TPTD for 12 months can effectively reduce the risk of NVCF and improve their quality of life.

关 键 词：特立帕肽 唑来膦酸 骨质疏松性骨折 骨质疏松 椎体骨折 椎体成形术 生活质量 背痛 线性模型 Logistic模型 

分 类 号：R681[医药卫生—骨科学] R683.2[医药卫生—外科学]