唑来膦酸联合高黏度经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的疗效分析  

Efficacy and prognosis of Zoledronic acid combined with high viscosity PVP in the treatment of osteoporotic vertebral compression fracture

作　　者：甘维[1] 朱柔霖 刘雪萍[1] 詹科剑 刘斌[1] Gan Wei;Zhu Roulin;Liu Xueping;Zhan Kejian;Liu Bin(Department of Spinal Surgery,Lishui People’s Hospital,Lishui 323000,China;Neonatology Department of Lishui People’s Hospital,Lishui 323000,China)

机构地区：[1]丽水市人民医院脊柱外科,丽水323000 [2]丽水市人民医院新生儿科,丽水323000

出　　处：《中华内分泌外科杂志（中英文）》2024年第2期279-282,共4页Chinese Journal of Endocrine Surgery

基　　金：丽水市科技计划项目(2021SJZC030)。

摘　　要：目的探讨唑来膦酸联合高黏度经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)的疗效及预后分析。方法选取2021年1月至2021年12月于丽水市人民医院接受诊治且随访至2022年12月的OVCF患者122例作为研究对象,按照随机数字表法分为观察组(予以唑来膦酸联合高黏度PVP术)与对照组(予以高黏度PVP术治疗),各61例。对比两组术前、术后1、3、6、12个月椎体Cobb角、责任椎椎高比、骨密度及不良反应发生率、1年再骨质率。结果重复测量方差分析显示,两组责任椎椎高比、椎体Cobb角、骨密度T值的时间效应、组间效应、时间与分组的交互作用比较,存在显著差异(F_(时点/组间/交互)=2633.61、1484、42.57,P均<0.000);术后1、3、6、12个月,观察组的责任椎椎高比为62.07±11.51、68.30±12.48、79.93±13.94、93.51±7.03、骨密度T值为-1.79±0.24、-1.05±0.19、-0.84±0.11、-0.68±0.08,高于对照组的57.79±10.05、61.99±10.67、71.09±12.15、84.55±10.01、-2.33±0.47、-1.87±0.30、-1.36±0.42、-1.09±0.25;椎体Cobb角的17.45±3.75、14.18±2.08、11.13±1.45、6.80±0.89,低于对照组的22.29±4.05、20.67±3.22、14.05±2.01、10.43±1.12(t_(责任椎椎高比)=2.31、3.18、3.95、5.90,P=0.022、0.002、0.000、0.000;t_(椎体Cobb角)=-6.83、-13.22、-9.18、-19.80,P均=0.000;t骨密度=8.04、18.03、9.38、12.18,P均=0.000)。观察组不良反应发生率与对照组相比,差异无统计学意义(P>0.05);观察组术后1年内再骨折率1.64%低于对照组11.48%(χ^(2)=4.82,P=0.028)。结论唑来膦酸联合高黏度PVP术治疗OVCF效果较好,且不增加不良反应。Objective To investigate the efficacy and prognosis of zoledronic acid combined with high viscosity PVP in the treatment of osteoporotic vertebral compression fracture(OVCF).Methods A total of 122 patients with osteoporotic vertebral compression fracture who received diagnosis and treatment in our hospital from Jan.2021 to Dec.2021 and were followed up until Dec.2022 were selected as research objects.According to the random number table,they were divided into the observation group(treated with zoredronic acid combined with high viscosity PVP)and the control group(treated with high viscosity PVP),with 61 cases in each group.Vertebral Cobb Angle,responsible vertebral height ratio,bone mineral density and incidence of adverse reactions,and re-bone rate of 1 year were compared between the two groups before surgery and 1,3,6 and 12 months after surgery.Results Repeated measurement analysis of variance showed that there were significant differences between the two groups in the time effect,intergroup effect and the interaction between time and group in the ratio of vertebral height,Cobb Angle of vertebral body,bone density T value(F _(Time point/inter-group/interaction)=2633.61,1484,42.57,P<0.000).At 1,3,6 and 12 months after surgery,the ratio of responsible vertebral(62.07±11.51,68.30±12.48,79.93±13.94,93.51±7.03),bone mineral density T value(-1.79±0.24,-1.05±0.19,-0.84±0.11,-0.68±0.08)is higher than the control group(57.79±10.05,61.99±10.67,71.09±12.15,84.55±10.01,-2.33±0.47,-1.87±0.30,-1.36±0.42,-1.09±0.25),The Cobb Angle of the vertebral body(17.45±3.75,14.18±2.08,11.13±1.45,6.80±0.89)was lower than that of the control group(22.29±4.05,20.67±3.22,14.05±2.01,10.43±1.12)(t _(responsible vertebral height ratio)=2.31,3.18,3.95,5.90,P=0.022,0.002,0.000,0.000;t _(vertebral Cobb Angle)=-6.83,-13.22,-9.18,-19.80,P=0.000,0.000,0.000,0.000,0.000;t_( bone mineral density T value=)8.04,18.03,9.38,12.18,P=0.000,0.000,0.000,0.000).There was no significant difference in the incidence of adverse reactions b

关 键 词：唑来膦酸 高黏度经皮椎体成形术 骨质疏松 椎体压缩性骨折 

分 类 号：R687.3[医药卫生—骨科学]