高压氧联合唑来膦酸治疗老年骨质疏松患者疗效及对骨密度、血清骨代谢生化标志物的影响  

Effects of hyperbaric oxygen combined with zoledronic acid on bone mineral density and serum bone metabolism markers in elderly patients with osteoporosis

作　　者：陈思静[1] 李玉洁 彭玲 Chen Sijing;Li Yujie;Peng Ling(Department of Pharmacy,Sichuan Electric Power Hospital,Chengdu 610000,China;Department of Pharmacy,The General Hospital of PLA Western Theater Command,Chengdu 610000,China)

机构地区：[1]四川电力医院药剂科,成都610000 [2]西部战区总医院药剂科,成都610000

出　　处：《中华航海医学与高气压医学杂志》2024年第6期780-784,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧联合唑来膦酸治疗老年骨质疏松患者的疗效及对骨密度、血清骨代谢生化标志物的影响。方法前瞻性选取2019年3月至2022年4月四川电力医院收治的86例老年骨质疏松患者,按照随机数表法分为对照组和研究组,每组43例。对照组给予唑来膦酸治疗,研究组给予高压氧联合唑来膦酸治疗。治疗前后分别采用双能X线骨密度检测仪检测患者腰椎L2-4与左股骨颈骨密度;分别在患者治疗前及治疗3个月后采用视觉模拟评分(VAS)评价患者的疼痛情况;治疗前后分别采用电化学发光法检测患者血清β-Ⅰ型胶原交联C-末端肽(β-CTX)、骨钙素N端中分子片段(N-MID)、Ⅰ型前胶原氨基末端肽(PⅠNP)、骨钙素(OC)、骨碱性磷酸酶(BAP)的水平,酶联免疫吸附法检测血清鸢尾素(irisin)水平;对比2组患者的临床疗效及不良反应率。结果2组患者治疗后腰椎L2-4、左股骨颈骨密度均高于治疗前,且治疗后研究组患者的骨密度均高于对照组,差异有统计学意义(P<0.05);治疗后研究组患者VAS均低于治疗前和对照组,差异有统计学意义(P<0.05);研究组患者治疗总有效率(90.70%)高于对照组(72.09%),差异有统计学意义(P<0.05);2组患者治疗后血清β-CTX、N-MID、PINP、OC、BAP水平均低于治疗前,血清irisin水平均高于治疗前;治疗后研究组患者上述指标的变化均比对照组明显,差异有统计学意义(P<0.05);2组患者治疗的不良反应发生率比较差异无统计学意义(P>0.05)。结论高压氧联合唑来膦酸治疗老年骨质疏松可增加患者骨密度,减轻疼痛,改善N-MID、β-CTX、irisin等骨代谢指标水平,有较好的临床疗效且安全可靠。Objective To investigate the efficacy of hyperbaric oxygen combined with zoledronic acid on elderly patients with osteoporosis and the effects on patients’bone mineral density(BMD)and serum bone metabolism markers.Methods A total of 86 elderly patients with osteoporosis admitted to Sichuan Electric Power Hospital from March 2019 to April 2022 were prospectively selected and divided into control group and study group according to the random number table method,with 43 cases in each group.The control group was given zoledronic acid treatment,and the study group was given hyperbaric oxygen combined with zoledronic acid treatment.The efficacy of treatment was evaluated after 3 months.The BMD of lumbar spine(L2-L4)and left femoral neck were measured by a dual-energy X-ray BMD detector before and after treatment.Visual analog scale(VAS)was used to evaluate the pain of the patients before treatment and after 3 months of the treatment,respectively.Serum levels ofβ-cross laps(β-CTx),molecular fragment of osteocalcin N terminal(N-MID),procollagen type I N-terminal propeptide(PⅠNP),osteocalcin(OC),and bone alkaline phosphatase(BAP)were detected by electrochemiluminescence before and after treatment.Serum irisin levels were detected by enzyme-linked immunosorbent assay.The clinical efficacy and incidence of adverse reactions of the two groups were compared.Results After treatment,the scores of BMD of lumbar spine(L2-L4)and left femoral neck in the two groups were higher than those before treatment,and these scores in the study group were higher than those in the control group after treatment,and the differences were statistically significant(P<0.05).The VAS scores for patients in the study group were lower than those before treatment and in the control group after treatment,and the differences were statistically significant(P<0.05).The total effective rate in the study group(90.70%)was higher than that in the control group(72.09%),and the difference was statistically significant(P<0.05).After treatment,the serum levels

关 键 词：骨质疏松 高压氧 唑来膦酸 骨代谢 临床疗效 

分 类 号：R580[医药卫生—内分泌]