椎体成形术联合唑来膦酸治疗绝经后骨质疏松性椎体骨折的疗效分析  

Curative effect analysis of PVP combined with Zoledronic acid in the treatment of postmenopausal osteoporotic vertebral fracture

作　　者：谢晶晶[1] 滕鹏 张波 宋烜[1] Xie Jingjing;Teng Peng;Zhang Bo;Song Xuan(Department of Orthopedics,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Chongming Branch,Shanghai 202150)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院骨科,上海202150

出　　处：《中华内分泌外科杂志》2023年第5期564-567,共4页Chinese Journal of Endocrine Surgery

摘　　要：目的探究椎体成形术(percutaneous vertebro plasty,PVP)联合唑来膦酸治疗绝经后骨质疏松性椎体骨折的疗效。方法选取2018年7月至2020年8月在上海交通大学医学院附属新华医院崇明分院治疗且符合标准的90例绝经后骨质疏松性椎体骨折患者,依据治疗方式的不同将患者分为观察组、对照组,两组患者均采用PVP治疗,对照组给于口服阿仑膦酸钠、骨化三醇胶丸和钙剂,观察组给唑来膦酸注射液静滴、口服骨化三醇胶丸和钙剂,治疗时间为1年。记录两组患者治疗前后腰椎、股骨颈、大粗隆及Ward三角骨密度(bone mineral density,BMD)、腰椎Oswestry功能障碍指数问卷表(Oswestry dability Index,ODI)指数及VAS评分、血清骨钙素(bone Gla-protein,BGP)、β-胶原特殊序列(βcollagen special sequence,β-CTX)、I型胶原氨基前端肽(type I procollagen amino-terminal peptide,PINP)水平及治疗过程中的不良反应。结果术后1年观察组患者腰椎ODI指数及VAS评分分别为(14.64±4.06 vs 2.57±1.12),术后1年对照组患者腰椎ODI指数及VAS评分分别为(19.32±3.84 vs 3.37±1.09),差异均有统计学意义(P=0.001,0.042)。术后1年观察组腰椎、股骨颈、大粗隆、Ward三角BMD高于对照组(P=0.000、0.000、0.000、0.000),血清BGP、β-CTX、PINP水平明显高于对照组(P=0.000、0.000、0.000),两组患者治疗过程中均未出现严重不良反应。结论唑来膦酸可明显改善骨质疏松性椎体压缩骨折患者PVP术后骨代谢,加速骨形成,增加患者BMD,减轻腰背部疼痛,改善腰椎功能,同时不良反应较少。Objective To explore the efficacy of PVP combined with zoledronic acid in the treatment of postmenopausal osteoporotic vertebral fractures.Method 90 patients with postmenopausal osteoporotic vertebral fractures treated in our hospital from Jul.2018 to Aug.2020 were selected.According to different treatment methods,the patients were divided into observation group and control group.The patients in both groups were treated with PVP.The patients in the control group were given oral alendronate,calcitriol capsules and calcium,and the patients in the observation group were given zoledronic acid injection,calcitriol capsules and calcium were taken orally for 1 year.BMD of lumbar spine,femoral neck,greater trochanter and ward triangle,lumbar ODI index and VAS score,serum BGP andβ-CTX,PINP levels and adverse reactions during treatment.Results One year after operation,the lumbar ODI index and VAS score of the observation group were significantly lower than those of the control group(P<0.05),and the BMD of lumbar spine,femoral neck,greater trochanter and ward triangle were higher than those of the control group(P<0.05).The levels of serum BGP,β-CTX and PINP levels in the two groups were significantly higher than those in the control group(P<0.05).Conclusion Zoledronic acid can significantly improve bone metabolism,accelerate bone formation,increase BMD,reduce low back pain and improve lumbar function in patients with osteoporotic vertebral compression fracture after PVP.

关 键 词：唑来膦酸 绝经后骨质疏松 椎体压缩性骨折 骨代谢 

分 类 号：R580[医药卫生—内分泌]