骨化三醇联合维生素K2对骨质疏松性椎体压缩性骨折术后效果及免疫指标的影响  

Effect of Calcitriol Combined with Vitamin K_(2) on Postoperative Efficacy and Immune Indexes of Osteoporotic Vertebral Compression Fracture

作　　者：王文莉[1] 袁忠[1] 万莉芳 黄莉 黄志华 WANG Wenli;YUAN Zhong;WAN Lifang;HUANG Li;HUANG Zhihua(Nanchang Hongdu Traditional Chinese Medicine Hospital,Nanchang 330000,China;不详)

机构地区：[1]南昌市洪都中医院,江西南昌330000

出　　处：《中国医学创新》2022年第36期49-53,共5页Medical Innovation of China

摘　　要：目的:探讨骨化三醇联合维生素K2对骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)术后疗效及对免疫指标的影响。方法:选取2017年4月-2019年5月南昌市洪都中医院收治的76例接受经皮椎体形成术治疗的OVCF患者。采用信封法将患者分为单纯组和联合组,各38例,单纯组口服骨化三醇,联合组在单纯组的基础上口服维生素K2。比较两组疗效、骨代谢指标[骨钙素(BGP)、骨碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶5b(TRACP5b)及Ⅰ型胶原交联羧基端肽(CTX-Ⅰ)]、免疫指标(CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+))、Cobb角和不良反应。结果:联合组总有效率为92.11%,高于单纯组的78.95%,但差异无统计学意义(P=0.103)。治疗前,两组BGP、BALP、TRACP5b、CTX-Ⅰ水平比较,差异均无统计学意义(P>0.05);治疗后,两组BGP水平均高于治疗前,TRACP5b、BALP及CTX-Ⅰ水平均低于治疗前,且联合组BGP水平高于单纯组,TRACP5b、BALP及CTX-Ⅰ水平均低于单纯组(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平比较,差异均无统计学意义(P>0.05);治疗后,两组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均高于治疗前,且联合组均高于单纯组(P<0.05)。治疗前,两组Cobb角比较,差异无统计学意义(P>0.05);治疗后,两组Cobb角均低于治疗前(P<0.05)。治疗后,两组Cobb角比较,差异无统计学意义(P>0.05)。两组不良反应发生率比较,差异无统计学意义(χ^(2)=0.239,P=0.625)。结论:骨化三醇联合维生素K2能够改善OVCF患者术后骨质代谢,提高免疫力且安全耐受,作为术后抗骨质疏松治疗方案值得参考。Objective:To investigate the effect of Calcitriol combined with Vitamin K2 on postoperative efficacy and immune indexes in osteoporotic vertebral compression fracture(OVCF).Method:A total of 76 patients with OVCF who received percutaneous vertebra formation in Nanchang Hongdu Traditional Chinese Medicine Hospital from April 2017 to May 2019 were selected,they were divided into simple group and combination group by envelope method,with 38 cases in each group.The simple group was given Calcitriol orally,and the combination group was given Vitamin K2 orally on the basis of the simple group.Efficacy,bone metabolism indexes [osteocalcin(BGP),bone alkaline phosphatase(BALP),tartrate-resistant acid phosphatase 5b(TRACP5b) and type Ⅰ collagen cross-linked carboxy-terminal peptide(CTX-Ⅰ)],immune indexes(CD3^(+),CD4^(+) and CD4^(+)/CD8^(+)),Cobb angle and adverse reactions were compared between the two groups.Result:The total effective rate of the combination group was 92.11%,which was higher than 78.95% of the single group,but the difference was not statistically significant(P=0.103).Before treatment,there were no significant differences in the levels of BGP,BALP,TRACP5b and CTX-Ⅰbetween the two groups(P>0.05);after treatment,the BGP levels in both groups were higher than those before treatment,TRACP5b,BALP and CTX-Ⅰ levels in both groups were lower than those before treatment,and the BGP level in the combination group was higher than that in the simple group,TRACP5b,BALP and CTX-Ⅰ levels in the combination group were lower than those in the simple group(P<0.05).Before treatment,there were no significant differences in the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) between two groups(P>0.05);after treatment,the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in both groups were higher than those before treatment,those in the combination group were higher than those in the simple group(P<0.05).Before treatment,there was no significant difference in Cobb angle between the two groups(P>0.05);after treatment,Cobb a

关 键 词：骨质疏松性椎体压缩性骨折 骨化三醇 维生素K2 

分 类 号：R687.3[医药卫生—骨科学]