阿仑膦酸钠在InterTan内固定治疗老年股骨粗隆间骨折中的近远期临床疗效分析  

Theraprutic effects of alendronate sodium combined with InterTan internal fixation on femoral intertrochanteric fractures in elderly patients

作　　者：王克猛[1] 魏世平[2] 孟庆聚 WANG Kemeng;WEI Shiping;MENG Qingju(Department of Osteology,The First Hospital Affiliated to Xingtai Medical High-grade Special School,Hebei,Xingtai 054001,China;不详)

机构地区：[1]邢台医学高等专科学校第一附属医院骨科,河北省邢台市054001 [2]邢台医学高等专科学校基础部

出　　处：《河北医药》2022年第10期1491-1495,共5页Hebei Medical Journal

摘　　要：目的探讨阿仑膦酸钠辅助InterTan内固定治疗老年股骨粗隆间骨折的近远期疗效。方法选取骨科2018年1月至2020年10月收治的126例骨质疏松性股骨粗隆间骨折患者,采用随机数字法将其分为对照组(n=56)和观察组(n=70),所有患者均行InterTan内固定治疗,术后对照组给予钙镁锌维生素D片,观察组在此基础上加以阿仑膦酸钠治疗,2组均连续治疗1年。比较2组治疗疗效、骨痂出现时间、骨折愈合时间及治疗前后的疼痛评分(VAS)、髋关节功能评分(Harris)、血清、尿骨代谢标志物水平[血清骨特异性碱性磷酸酶(B-ALP)、骨钙素(BGP)、Ⅰ型前胶原N端前肽(PINP)、抗酒石酸酸性磷酸酶(TRACP)5b、尿吡啶啉(PYD)、Ⅰ型胶原C端肽(CTX)]、血清炎性因子水平[血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、单核细胞趋化因子蛋白-1(MCP-1)、降钙素原(PCT)、白细胞介素-10(IL-10)、转化生长因子-β(TGF-β)],并比较2组治疗前及术后各阶段的髋部骨密度(BMD)。结果观察组的治疗总有效率显著高于对照组,骨痂出现时间、骨折愈合时间均显著短于对照组,VAS评分显著低于对照组,Harris评分显著高于对照组,差异均有统计学意义(P<0.05);治疗后,观察组的血清、尿骨代谢标志物水平[B-ALP、BGP、PINP、(TRACP)5b、PYD、CTX]水平以及血清炎性因子(IL-6、TNF-α、MCP-1、PCT)均明显低于对照组,炎性因子IL-10、TGF-β均明显高于对照组,差异均有统计学意义(P<0.05);术后1、3、6、12个月,观察组BMD均明显大于对照组(P<0.05)。结论在InterTan内固定术的基础上加以阿仑膦酸钠可显著提高老年股骨粗隆间骨折的治疗疗效,改善患者机体骨代谢水平、炎性水平,提高其BMD,加快骨折愈合,值得在临床推广。Objective To investigate the theraprutic effects of alendronate sodium combined with InterTan internal fixation on femoral intertrochanteric fractures in elderly patients.Methods A total of 126 patients with osteoporotic intertrochanteric fracture,who were treated in our hospital from January 2018 to October 2020,were randomly divided into control group(n=56)and observation group(n=70).The patients in both groups were treated by InterTan internal fixation.After treatment,the patients in control group were given calcium,magnesium,zinc and vitamin D tablets,however,those in observation group,on the basis of control group,were treated by alendronate,with a treatment course of 1 year for both groups.The efficacy,occurrence time of callus,fracture healing time,pain score(VAS)before and after treatment,hip function score(Harris),and serum and urine bone metabolism indexes[B-ALP,BGP,PINP,(TRACP)5b,PYD,CTX],and the serum levels of inflammatory factors(IL-6,TNF-α,MCP1,PCT,IL-10,TGF-β)as well as the BMD levels before and after treatment were observed and compared between the two groups.Results The total effective rate in observation group was significantly higher than that in control group and the occurrence time of callus and fracture healing time in observation group were significantly shorter than those in control group.The VAS score,the Harris score in observation group were significantly lower and higher than those in control group,respectively(P<0.05).Moreover,the serum levels of urine bone metabolism indexes[B-ALP,BGP,PINP,(TRACP)5b,PYD,CTX]and serum levels of IL-6,TNF-α,MCP1,and PCT in observation group were significantly lower than those in control group,while the levels of IL-10 and TGF-βwere significantly higher than those in control group(P<0.05).In addition,the BMD at 1m,3m,6m and 12m after surgery in observation group were significantly higher than those in control group(P<0.05).Conclusion Alendronate sodium combined with InterTan internal fixation is very effective in treating femoral intertrochanteric f

关 键 词：阿仑膦酸钠 InterTan内固定 老年股骨粗隆间骨折 临床疗效 骨密度 

分 类 号：R683.42[医药卫生—骨科学]