阿仑膦酸钠联合钙剂预防经皮椎体成形术术后二次骨折的效果观察  

Observation of the effect of alendronate sodium combined with calcium supplements in preventing secondary fractures after PVP for OVCF

作　　者：张凯[1] 张英民[1] 康少英[1] 杨武燕 张金盼 ZHANG Kai;ZHANG Ying-min;KANG Shao-ying;YANG Wu-yan;ZHANG Jin-pan(Department of Spinal Surgery,Central Hospital of Handan City,Hebei Province,Handan 056000,China)

机构地区：[1]河北省邯郸市中心医院脊柱外科,河北邯郸056000

出　　处：《河北医科大学学报》2023年第8期915-919,933,共6页Journal of Hebei Medical University

基　　金：邯郸市科学技术研究与发展计划(21422083134)。

摘　　要：目的探讨阿仑膦酸钠联合钙剂预防骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)行经皮椎体成形术(percutaneous vertebroplasty,PVP)术后二次骨折的效果。方法选取OVCF行PVP患者128例。根据术后抗骨质疏松用药方案分为对照组71例(碳酸钙D3+骨化三醇)、研究组57例(碳酸钙D3+骨化三醇+阿仑膦酸钠)。分析2组不同时期骨代谢指标、影像学参数、股骨颈骨密度及术后椎体二次骨折发生率。结果2组血清Ⅰ型胶原羧基端肽β特殊序列(typeⅠcollagen carboxy terminal peptideβspecial sequence,β-CTX)、Ⅰ型前胶原氨基端前肽(typeⅠprocollagen N-terminal prepetide,PINP)水平均随时间延长有下降趋势,研究组下降趋势比对照组更明显,2组组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05),2组伤椎椎体前缘高度比值及矢状面Cobb角、股骨颈骨密度随时间均呈增大趋势,研究组增大趋势比对照组更为明显,2组组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05),研究组术后椎体二次骨折总发生率低于对照组(P<0.05)。结论阿仑膦酸钠联合钙剂能改善PVP术后患者骨代谢,增加骨密度,降低术后椎体二次骨折发生率,值得临床推广。Objective To investigate the effect of alendronate sodium combined with calcium supplements in preventing secondary fractures after percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fractures(OVCF).Methods In total,128 patients with OVCF undergoing PVP were selected.According to different antiosteoporosis medication schemes after operation,patients were divided into the control group(calcium carbonate D3+calcitriol,n=71)and the research group(calcium carbonate D3+calcitriol+alendronate sodium,n=57).The bone metabolic indicators,imaging parameters and incidence of secondary vertebral fracture in the two groups during different periods were analyzed.Results The levels of serum typeⅠcollagen carboxy terminal peptideβspecial sequence(β-CTX)and typeⅠprocollagen N-terminal prepetide(PINP)in both groups showed a downward trend with time,and the downward trend of the research group was more obvious than that of the control group;There were significant differences in the interaction between groups,time points,and time points between groups(P<0.05).The height ratio of the anterior edge of the injured vertebral body,the Cobb angle in the sagittal plane,and the bone density of the femoral neck in both groups showed an increasing trend with time.The increasing trend in the research group was more obvious than that in the control group,and there were significant differences in the interaction between groups,time points,and time points between groups(P<0.05).The total incidence of postoperative secondary fracturesof vertebral body in the research group was lower than that in the control group(P<0.05).Conclusion Combination of alendronate sodium and calcium supplements can improve bone metabolism,increase bone mineral density,and reduce the incidence of secondary vertebral fractures in patients undergoing PVP.Therefore,it is worthy of clinical promotion.

关 键 词：椎体成形术 阿仑膦酸钠 钙剂 

分 类 号：R687.4[医药卫生—骨科学]