唑来膦酸在骨质疏松合并脊柱结核综合治疗中的疗效观察

发布时间：2019-06-27 14:13

【摘要】：目的探讨唑来膦酸在骨质疏松合并脊柱结核综合治疗中的疗效。方法将我科2010年~2013年收治的40例脊柱结核伴骨质疏松患者分为A、B两组,A组20例,为治疗组,平均年龄67.4±5.32岁,术后静脉滴注唑来膦酸5mg,并口服钙尔奇D片2片/天,持续12个月;B组20例,为对照组,平均年龄65.3±6.54岁。给予口服钙尔奇D片2片/天以及阿尔法D30.25μg/d,持续12个月。观察治疗前后两组患者股骨颈(Neck)骨密度、血沉(ESR)、血清β-Ⅰ型胶原交联羧基末端肽(β-CTX)、骨特异性碱性磷酸酶(BALP)以及影像学的变化情况。结果所有患者均顺利完成手术治疗,随访时间1~2.7年,平均1.8年。A、B两组术前股骨颈(Neck)骨密度、ESR、β-CTX、BALP均无明显差异。治疗后A组股骨颈(Neck)骨密度显著高于B组(P0.05),A组患者治疗后β-CTX较术前下降明显(P0.05),BALP与术前比较无统计学差异(P0.05)。B组患者β-CTX、BALP与治疗前比较无明显差异(P0.05),治疗后A组β-CTX较B组下降明显,有统计学意义(P0.05),BALP组间比较无明显差异(P0.05)。A、B组治疗后ESR均较术前缓解明显(P0.05),组间比较无明显差异(P0.05)。术后影像学资料提示随访患者均获得Ⅰ级植骨融合,植骨融合率100%,末次随访时未发生断钉断棒情况,B组3例患者内固定松动,余患者内固定位置良好,无明显内固定移位,组间比较无明显差异(P0.05)。结论唑来膦酸在骨质疏松合并脊柱结核的综合治疗中可取得良好的效果。
[Abstract]:Objective To study the effect of the treatment of the treatment of the combined spinal tuberculosis in the patients with osteoporosis. Methods From 2010 to 2013,40 cases of spinal tuberculosis with osteoporosis were divided into group A and group B. In group A,20 cases were treated. The average age was 67.4 to 5.32 years, the average age was 67.4 to 5.32 years, and the average age was 67.4 to 5.32 years. The mean age was 65.3 and 6.54 years for the control group. 2 tablets/ day and alpha D30.25 & mu; g/ d were administered for 12 months. The changes of bone mineral density, erythrocyte sedimentation rate (ESR), serum type I-I collagen cross-linked terminal peptide (I-CTX), bone-specific alkaline phosphatase (BALP) and imaging were observed in the two groups before and after treatment. Results All patients were successfully treated and the follow-up time was 1-2.7 years, with an average of 1.8 years. The results showed that there were no significant differences in bone mineral density, ESR, P-CTX and BALP in the group A and group B before and after operation. The BMD of the femoral neck (Neck) in group A was significantly higher than that in group B (P0.05). In group A, P-CTX in group A was significantly lower than that before operation (P0.05). There was no significant difference between BALP and pre-operative treatment (P0.05). There was no significant difference between group A and group B in group A after treatment (P0.05). There was no significant difference between group A and group B (P0.05). The ESR in group A and group B was significantly lower than that in group B (P0.05). There was no significant difference between groups (P0.05). The postoperative imaging data indicated that all follow-up patients received grade I bone fusion, the fusion rate of bone graft was 100%, no nail-breaking was occurred at the time of last follow-up,3 patients in group B were fixed and loose, the fixed position in the remaining patients was good, and no significant internal fixation and displacement were found. There was no significant difference between the groups (P0.05). Conclusion The results showed that the treatment of the treatment of osteoporosis and spinal tuberculosis could have a good effect on the treatment of osteoporosis.
【作者单位】：河北北方学院;解放军第309医院;
【基金】：全军医学科技青年培育项目(4241287K)
【分类号】：R580;R529.2

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