地舒单抗与唑来膦酸在老年髋部骨折患者术后治疗中的应用效果比较  

Comparative study on the efficacy of denosumab and zoledronic acid in the postoperative treatment of elderly patients with hip fracture

作　　者：周伟峰 陈欢 吕宁 ZHOU Weifeng;CHEN Huan;LYU Ning(Department of Orthopedics,Central Theater Command General Hospital,Wuhan 430000,China)

机构地区：[1]中部战区总医院骨科,武汉市430000

出　　处：《临床合理用药》2025年第3期32-35,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 比较地舒单抗与唑来膦酸在老年髋部骨折患者术后治疗中的应用效果。方法 选取2021年1月—2023年6月中部战区总医院收治的146例老年髋部骨折术后患者作为研究对象,采用随机数字表法将患者分为对照组和观察组,各73例。2组患者行髋关节置换术或闭合复位髓内钉内固定术,术后对照组给予唑来膦酸注射液治疗,观察组给予地舒单抗,2组患者均用药1年。比较2组用药前后髋关节Harris功能评分(Harris评分)、假体或内固定物周围骨密度、骨代谢指标及不良反应。结果 用药1年后,2组Harris评分较用药前升高,对照组假体或内固定物周围骨密度较用药前下降,但观察组Harris评分、假体或内固定物周围骨密度高于对照组(P<0.01);2组人抗酒石酸酸性磷酸酶5b、骨钙素水平降低,骨碱性磷酸酶、25-羟维生素D水平升高,且观察组降低/升高幅度大于对照组(P<0.05或P<0.01)。对照组与观察组不良反应总发生率比较,差异无统计学意义(6.85%vs. 5.48%,P=1.000)。结论 与唑来膦酸相比,老年髋部骨折患者术后应用地舒单抗具有较好疗效,其可更有效地改善患者髋关节功能,减少骨量丢失,抑制破骨细胞活性,更有利于改善骨代谢、促进骨形成,且安全性较高。Objective To compare the efficacy of denosumab and zoledronic acid in the postoperative treatment of elderly patients with hip fracture.Methods A total of 146 elderly patients with hip fracture after operation admitted to the Central Theater Command General Hospital from January 2021 to June 2023 were selected,and they were divided into the control group and the observation group by random number table method,with 73 cases in each group.Two groups of patients were received hip arthroplasty or closed reduction and intramedullary nail fixation.After surgery,patients in the control group were treated with zoledronic acid injection,while patients in the observation group were treated with denosumab.Both groups were treated for one year.Harris score,bone mineral density around the prosthesis or internal fixator,bone metabolism indicators before and after medication,and adverse reactions were compared between the two groups.Results One year after medication,the Harris score of the two groups increased compared with those before medication,bone mineral density around the prosthesis or internal fixator in the control group decreased compared with that before medication,but the Harris score and bone mineral density around the prosthesis or internal fixator in the observation group were higher than those in the control group(P<0.01);Levels of TRAP-5b,BGP decreased,while the levels of BALP,25(OH)D 3 increased in the two groups,and decrease/increase amplitude in the observation group were greater than those of the control group(P<0.05 or P<0.01).There was no statistically significant difference in the total incidence of adverse reactions between the control group and the observation group(6.85%vs.5.48%,P=1.000).Conclusion Compared with zoledronic acid,denosumab has better efficacy in the postoperative treatment of elderly patients with hip fracture,it can more effectively improve hip joint function,reduce bone loss,inhibit osteoclast activity,and is more conducive to improving bone metabolism and promoting bone formation,wit

关 键 词：髋部骨折 老年人 地舒单抗 唑来膦酸 骨密度 骨代谢 

分 类 号：R687.3[医药卫生—骨科学]