| 杨文诚,吴益奇,苏万汉,林需枰,卢海川.唑来膦酸治疗骨质疏松性椎体压缩性骨折疗效分析[J].中国烧伤创疡杂志,2025,(4):301~305. |
| DOI： |
| 中文关键词: 骨质疏松性椎体压缩性骨折 骨代谢 椎体功能 骨化三醇 再骨折 唑来膦酸 |
| 英文关键词:Osteoporotic vertebral compression fracture Bone metabolism Vertebral function Calcitriol Refacture Zoledronic acid |
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| 中文摘要: |
| 【摘要】 目的 分析唑来膦酸在骨质疏松性椎体压缩性骨折患者中的应用效果。 方法 选取2020年10月至2023年10月龙岩市第一医院收治的110例骨质疏松性椎体压缩性骨折患者为研究对象, 按照随机数表法将其随机分为研究组 (55 例) 与对照组 (55 例)。 经皮椎体成形术后, 研究组患者在口服碳酸钙 D3 及骨化三醇基础上加用唑来膦酸, 对照组患者仅口服碳酸钙 D3 及骨化三醇, 对比观察两组患者手术情况、恢复正常活动与骨折愈合时间、伤椎 Cobb 角与前缘高度、椎体功能以及甲状旁腺激素(PTH)、N端中段骨钙素(N-MID)、β-Ⅰ型胶原交联羧基末端肽(β-CTX)水平与再骨折发生情况。 结果 研究组患者手术时间、骨水泥注入量与对照组无明显差异 (t = 0.870、0.982, P = 0.387、0.328), 而恢复正常活动时间、骨折愈合时间均短于对照组 (t = 15.071、12.572, P 均<0.001); 治疗 3、6 个月后, 研究组患者伤椎 Cobb 角小于对照组、前缘高度及日本骨科协会 (JOA) 评分、N-MID 水平均高于对照组（伤椎 Cobb角: t = 5.357、5.242, P均<0.001; 伤椎前缘高度: t = 5.714、5.008, P 均< 0.001; JOA 评分: t = 4.983、5.996, P 均<0.001; N-MID: t = 4.635、4.945, P 均 < 0.001）, Oswestry 功能障碍指数（ODI）评分及 PTH、β-CTX 水平均低于对照组 (ODI 评分: t = 7.430、10.481, P 均<0.001; PTH: t = 3.328、3.003, P = 0.001、0.003; β-CTX: t=4.311、7.240, P均<0.001); 术后随访 6 个月, 研究组患者再骨折发生率与对照组无明显差异 ( χ 2 = 3.814, P = 0.051)。 结论 在口服碳酸钙D3及骨化三醇基础上加用唑来膦酸更有利于改善骨质疏松性椎体压缩性骨折患者骨代谢水平, 提高经皮椎体成形术后椎体结构及功能的恢复效果。 |
| 英文摘要: |
| 【Abstract】 Objective To analyze the clinical efficacy of zoledronic acid in patients with osteoporotic vertebral compression fractures. Methods 110 osteoporotic vertebral compression fractures patients admitted to Longyan First Hospital from October 2020 to October 2023 were enrolled as research subjects, and divided, using the random number table, into the study group (n = 55) and the control group (n = 55). After percutaneous vertebroplasty, patients in the study group were treated with zoledronic acid in addition to oral calcium carbonate D3 and calcitriol, while patients in the control group only received oral calcium carbonate D3 and calcitriol. The surgical conditions, time to return to normal activities and fracture healing time, Cobb angle, height of the anterior edge of the injured vertebrae, vertebral function, levels of parathyroidhormone (PTH), N-terminal middle osteocalcin (N-MID), β-type Ⅰ collagen carboxy-terminal peptide (β-CTX) , and the occurrence of refracture were compared between the two groups. Results There were no significant differences in operative time or bone cement injection volume of patients between the two groups (t = 0?? 870 and 0?? 982, P= 0?? 387 and 0?? 328). The time to return to normal activities and fracture healing time of patients in the study group was shorter than that in the control group (t = 15?? 071 and 12?? 572, both P<0?? 001). Respectively at 3 and 6 months of treatment, the Cobb angle of the injured vertebrae was smaller, the anterior height and Japanese Orthopaedic Association (JOA) score were higher, and the level of N-MID was higher in the study group than the control group (Cobb angle: t = 5?? 357 and 5?? 242, both P<0?? 001; anterior height: t = 5?? 714 and 5?? 008, both P<0?? 001; JOA score: t = 4?? 983 and 5?? 996, both P<0?? 001; N-MID: t = 4?? 635 and 4?? 945, both P<0?? 001). The Oswestry disability index (ODI) score and levels of PTH and β-CTX were lower in the
study group (ODI score: t = 7?? 430 and 10?? 481, both P< 0?? 001; PTH: t = 3?? 328 and 3?? 003, P = 0?? 001 and 0?? 003; β-CTX: t = 4?? 311 and 7?? 240, both P<0?? 001). During the 6-month follow-up after surgery, there was no significant difference in the incidence of refracture between the study group and the control group (χ 2 = 3?? 814, P= 0?? 051). Conclusion The combined application of zoledronic acid on the basis of oral calcium carbonate D3 and calcitriol is more effective in improving bone metabolism levels and enhancing the recovery of vertebral structure and function after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures. |
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