鹿瓜多肽联合经皮椎弓根螺钉固定术对胸腰椎爆裂性骨折患者疗效与安全性  

Efficacy and safety of Lugua polypeptide combined with percutaneous pedicle screw fixation in patients with thoracolumbar burst fractures

作　　者：裴金乐 王海羽 刘念[1] 童磊[1] 付勇力 丁远飞 李都 程龙 Pei Jin-le;Wang Hai-yu;Liu Nian;Tong Lei;Fu Yong-li;Ding Yuan-fei;Li Du;Cheng Long(Department of Orthopedics,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院骨科,南阳473000

出　　处：《中国药物应用与监测》2024年第6期805-808,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：目的探讨鹿瓜多肽联合经皮椎弓根螺钉固定术对胸腰椎爆裂性骨折患者的疗效与安全性。方法选取南阳市中心医院骨科2022年3月至2024年3月收治的82例胸腰椎爆裂性骨折患者,经随机数字表法分为鹿瓜多肽联合组和手术固定组,两组各41例。两组患者均行经皮椎弓根螺钉固定术,鹿瓜多肽联合组加用鹿瓜多肽连续治疗15 d。比较两组患者视觉模拟评分(VAS)、骨代谢指标、Oswestry功能障碍指数、椎体高度比与脊柱后凸角(Cobb角)以及不良反应发生情况。结果治疗后两组患者VAS评分、Oswestry功能障碍指数均下降,β胶原羧基端交联肽(β-CTX)、Ⅰ型胶原氨基端前肽(PINP)、骨钙素(BGP)水平均上升(P<0.05),Cobb角均减小(P<0.05),且鹿瓜多肽联合组VAS评分和Oswestry功能障碍指数低于手术固定组[(0.79±0.23)分vs(0.96±0.34)分,(23.24±7.25)%vs(28.26±9.33)%],鹿瓜多肽联合组β-CTX、PINP、BGP水平高于手术固定组[(5.26±0.89)ng·mL^(-1)vs(4.87±0.78)ng·mL^(-1),(234.61±26.15)μg·mL^(-1)vs(221.84±23.10)μg·mL^(-1),(31.89±5.04)ng·mL^(-1)vs(28.65±4.97)ng·mL^(-1)](t=2.652、2.720、2.110、2.343、2.931,均P<0.05)。两组椎体前缘、后缘高度比[(50.06±8.23)%vs(49.34±8.07)%、(63.81±7.99)%vs(65.06±8.59)%]、治疗后Cobb角[(4.36±0.89)°vs(4.56±0.93)°]、不良反应发生率(19.51%vs 12.20%),差异无统计学意义(t=1.489、1.123、0.995,χ^(2)=0.823,P>0.05)。结论鹿瓜多肽联合经皮椎弓根螺钉固定术能够减轻胸腰椎爆裂性骨折患者疼痛感受和腰部功能障碍,改善患者骨代谢功能,并不会影响治疗的安全性。Objective To investigate the effectiveness and safety of percutaneous pedicle screw fixation in conjunction with Lugua polypeptide in patients suffering from thoracolumbar burst fractures.Methods A total of 82 patients with thoracolumbar burst fractures admitted to Nanyang Central Hospital from March 2022 to March 2024 were selected and divided into the Lugua polypeptide combination group and the surgical fixation group using the random number table method,with 41 in each group.All the patients in both groups underwent percutaneous pedicle screw fixation,and those in the Lugua polypeptide combined group received treatment with Lugua polypeptide for 15 days in addition.The visual analog scores,bone metabolism indexes,Oswestry disability index,vertebral body height ratio and kyphosis angle,and occurrence of adverse reactions were compared between the two groups.Results After treatment,the visual analogue scale and Oswestry disability index were remarkably decreased but the levels ofβ-collagen carboxy-terminal cross-linked peptide(β-CTX),type I collagen amino-terminal propeptide(PINP),and osteocalcin(BGP)increased in both groups(P<0.05).Moreover,the Cobb angles were all reduced(P<0.05).The VAS score and Oswestry dysfunction index were significantly lower whileβ-CTX,PINP and BGP levels higher in the Lugua polypeptide combined group than in the surgical fixation group((0.79±0.23)points vs(0.96±0.34)points,(23.24±7.25)%vs(28.26±9.33)%,(5.26±0.89)ng·mL^(-1)vs(4.87±0.78)ng·mL^(-1),(234.61±26.15)μg·mL^(-1)vs(221.84±23.10)μg·mL^(-1),(31.89±5.04)ng·mL^(-1)vs(28.65±4.97)ng·mL^(-1))(t=2.652,2.720,2.110,2.343,2.931,all P<0.05).The height ratio of the anterior and posterior edges of the vertebral bodies was not significantly different between the two groups((50.06±8.23)%vs(49.34±8.07)%,(63.81±7.99)%vs(65.06±8.59)%,P>0.05).Meanwhile,there were no statistically significant differences in Cobb angle and incidence of adverse reactions after treatment between the two groups((4.36±0.89)°vs(4.56±0.93)°,19.

关 键 词：胸腰椎爆裂性骨折 经皮椎弓根螺钉固定术 鹿瓜多肽 骨代谢指标 OSWESTRY功能障碍指数 

分 类 号：R687.3[医药卫生—骨科学]