唑来膦酸注射液联合碳酸钙治疗老年骨质疏松的临床疗效及对患者骨密度的影响  

Clinical efficacy of zoledronic acid injection combined with calcium carbonate in the treatment of elderly patients with osteoporosis and its effect on bone mineral density

作　　者：邹金兵 刘仕翔[1] 徐江奇 ZOU Jinbing;LIU Shixiang;XU Jiangqi(Department of Geriatric,Jiujiang First People's Hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院老年科,江西九江332000

出　　处：《当代医学》2024年第24期37-41,共5页Contemporary Medicine

摘　　要：目的探讨唑来膦酸注射液联合碳酸钙治疗老年骨质疏松(osteoporosis,OP)的临床疗效及对患者骨密度(bone mineral density,BMD)的影响。方法选取2020年1月至2022年12月九江市第一人民医院收治的80例老年OP患者作为研究对象,采用抽签法分为联合组与参照组,每组40例。参照组给予钙尔奇碳酸钙D_(3)咀嚼片,联合组在参照组基础上静脉滴注唑来膦酸注射液。比较两组临床疗效、静息和活动状态下疼痛状况[视觉模拟评分法(visual analog scale,VAS)]、BMD、血清25羟基维生素D_(3)[25-hydroxy vitamin-D_(3),25(OH)D_(3)]、甲状旁腺激素(parathyroid hormone,PTH)、骨代谢[骨钙素(osteocalcin,OC)、骨保护素(osteoprotegerin,OPG)、骨特异性碱性磷酸酶(bone specific alkaline phosphatase,BALP)]水平及不良反应发生率。结果联合组治疗总有效率为92.50%,高于参照组的75.00%,差异有统计学意义(P<0.05)。治疗3个月后,两组静息、活动状态下VAS评分均低于治疗前,且联合组低于参照组,差异有统计学意义(P<0.05)。治疗3个月后,两组腰椎、股骨颈BMD均高于治疗前,联合组腰椎、股骨颈、大转子BMD均高于参照组,差异有统计学意义(P<0.05),两组治疗前后大转子BMD比较差异无统计学意义。治疗3个月后,两组血清25(OH)D_(3)水平高于治疗前,PTH水平低于治疗前,且联合组血清25(OH)D_(3)水平高于参照组,PTH水平低于参照组,差异有统计学意义(P<0.05)。治疗3个月后,两组血清OC、OPG、BALP水平高于治疗前,且联合组高于参照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论唑来膦酸注射液联合碳酸钙治疗OP患者可提高临床疗效,缓解患者疼痛,增加其BMD,并改善骨代谢水平,且安全性较高。Objective To investigate the clinical efficacy of zoledronic acid injection combined with calcium carbonate in the treatment of elderly patients with osteoporosis(OP)and its effect on bone mineral density(BMD).Methods A total of 80 elderly patients with OP who were treated in Jiujiang First People's Hospital from January 2020 to December 2022 were selected as the research subjects,they were divided into the combined group and the reference group by drawing lots,with 40 cases in each group.The reference group was given caltrate calcium carbonate D_(3) Chewable tablets,and the combined group was intravenously injected with zoledronic acid injection on the basis of the reference group.The clinical efficacy,pain status(visual analog scale[VAS])inresting and actives states,BMD,serum 25-hydroxy vitamin D_(3)(25[OH]D_(3)),parathyroid hormone(PTH),bone metabolism(osteocalcin[OC],osteoprotegerin[OPG],bone specific alkaline phosphatase[BALP])and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of treatment in the combined group was 92.50%,which was higher than 75.00%in the reference group,and the difference was statistically significant(P<0.05).After 3 months of treatment,the VAS scores in resting and actives states of the two groups were lower than those before treatment,and the combined group was lower than the reference group,the differences were statistically significant(P<0.05).After 3 months of treatment,the BMD of lumbar spine and femoral neck of the two groups were higher than those before treatment,and the BMD of lumbar spine,femoral neck and greater trochanter in the combined group were higher than those in the reference group,the differences were statistically significant(P<0.05),there was no significant difference in the BMD of greater trochanter between the two groups before and after treatment.After 3 months of treatment,the serum 25(OH)D_(3) level of the two groups was higher than that before treatment,and the PTH level was lower than that before treatm

关 键 词：唑来膦酸 碳酸钙 老年骨质疏松患者 骨密度 

分 类 号：R58[医药卫生—内分泌]