Intertan内固定联合阿仑膦酸钠对骨质疏松性股骨粗隆间骨折患者骨代谢及骨密度的影响  

Effects of Intertan internal fixation combined with alendronate on the bone metabolism and bone mineral density in patients with osteoporotic femoral intertrochanteric fracture

作　　者：王克猛[1] 魏世平[2] 孟庆聚 于利娟 牛军强[1] 王海燕 豆重印 牛长磊 孔玉明 李墨 WANG Kemeng;WEI Shiping;MENG Qingju(Department of Osteology,The First Hospital Affiliated to Xingtai Medical 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21期3255-3258,3263,共5页Hebei Medical Journal

摘　　要：目的探讨Intertan内固定联合阿仑膦酸钠对骨质疏松性股骨粗隆间骨折患者骨代谢及骨密度影响。方法选取2018年1月至2020年10月收治的骨质疏松性股骨粗隆间骨折患者110例,采用随机数字法分为对照组(n=50)和观察组(n=60),对照组行InterTan内固定治疗,观察组在对照组基础上给予阿仑膦酸钠治疗,2组均干预1年,比较2组治疗疗效以及治疗前后的骨代谢指标[血清骨特异性碱性磷酸酶(BALP)、软骨寡聚基质蛋白(COMP)、骨桥蛋白(OPN)、抗酒石酸酸性磷酸酶异构体5b(TRACP-5b)]、骨密度以及炎性水平[红细胞沉降率(ESR)、血清C-反应蛋白(CRP)],比较2组治疗后髋关节功能(Harris)评分优良率以及术后并发症发生率。结果观察组的治疗总有效率(88.33%)明显高于对照组(54.00%)(P<0.05);观察组患者的血清BALP、COMP、OPN、TRACP-5b水平明显低于对照组,股骨颈、大粗隆、转子间的骨密度明显大于对照组,ESR、血清CRP水平均明显低于对照组(P<0.05);观察组的Harris评分优良率(81.67%)明显高于对照组(52.00%),术后并发症发生率(11.67%)明显低于对照组(34.00%)(P<0.05)。结论Intertan内固定联合阿仑膦酸钠可显著改善骨质疏松性股骨粗隆间骨折骨代谢及骨密度,提高其治疗疗效,降低患者炎性反应,且安全性高,值得推广。Objective To investigate the effects of Intertan internal fixation combined with alendronate on the bone metabolism and bone mineral density in patients with osteoporotic femoral intertrochanteric fracture.Methods A total of 110 patients with osteoporotic intertrochanteric fracture who were treated in our hospital from January 2018 to October 2020 were enrolled in the study,who were randomly divided into control group(n=50)and observation group(n=60).The patients in control group were treated by Intertan internal fixation,however,those in observation group,on the basis of control group,were treated by alendronate sodium,with the intervention of 1 year for both groups.The therapeutic effects,and bone metabolism indexes before and after treatment[serum bone-specific alkaline phosphatase(BALP),cartilage oligomeric matrix protein(COMP),osteopontin(OPN),anti-tartrate acid phosphatase isomer 5b(TRACP-5b)],bone density and inflammatory level[erythrocyte sedimentation rate(ESR),serum C-reactive protein(CRP)],and the good/excellent rate of hip joint function(Harris)score and the incidence of postoperative complications were observed and compared between the two groups.Results The total effective rate in observation group was 88.33%,which was significantly higher than that(54.00%)in control group(P<0.05).The serum levels of BALP,COMP,OPN,and TRACP-5b in observation group were significantly lower than those in control group.The bone density values of femoral neck,greater trochanter and intertrochanteric bone in observation group were significantly higher than those in control group,however,the serum levels of ESR and CRP in observation group were significantly lower than those in control group(P<0.05).Moreover the good/excellent rate of Harris score in observation group was 81.67%,which was significantly higher than that(52.00%)in control group,and the incidence of postoperative complications in observation group was 11.67%,which was significantly lower than that(34.00%)in control group(P<0.05).Conclusion Intertan internal

关 键 词：Intertan内固定 阿仑膦酸钠 骨质疏松性 股骨粗隆间骨折 骨代谢 骨密度 

分 类 号：R683[医药卫生—骨科学]