唑来膦酸结合钙尔奇对老年脑梗死合并骨质疏松症患者疗效影响的临床研究

发布时间：2018-05-09 07:00

本文选题：脑梗死 + 骨质疏松　；参考：《中国骨质疏松杂志》2017年11期

【摘要】：目的研究老年脑梗死合并骨质疏松症患者应用唑来膦酸结合钙尔奇对患者骨密度、生化与骨代谢相关指标的影响。方法 98例脑梗死急性期后伴肢体瘫痪合并骨质疏松症患者,按随机数字表法将其分为治疗组(n=49)及对照组(n=49)。对照组给予钙尔奇治疗,治疗组给予唑来膦酸联合钙尔奇治疗,为期6个月。检测治疗后两组患者腰椎1~4(L_(1~4))、股骨颈骨密度及血钙(Ca)、血磷(P)、25羟基维生素D[25(OH)D3]、甲状旁腺素(parathyroid hormone,PTH)、骨钙素(osteocalcin,OC)、1型胶原羧基末端肽(type 1 collagen carboxyl terminal peptide,β-CTX)、1型前胶原氨基端肽(type 1 procollagen amino terminal peptide,P1NP)、骨源性碱性磷酸酶(bone alkaline phosphatase,BALP)水平的变化情况。记录两组患者药物的不良反应。结果治疗后6个月,治疗组腰椎1~4(L_(1~4))、股骨颈骨密度均显著高于同时期对照组(P0.05);治疗后6个月,治疗组患者血清PTH、OC、P1NP、BALP均显著高于治疗前(P0.05),而25(OH)D3及β-CTX均显著低于治疗前(P0.05),而Ca、P差异无统计学意义(P0.05)。两组药品不良反应发生率比较,差异无统计学意义(P0.05)。结论唑来膦酸联合钙剂可提升老年脑梗死患者骨密度,改善骨代谢状态,可以安全有效地防治老年脑梗死骨质疏松症。
[Abstract]:Objective to study the effects of zoledronic acid combined with calcium on bone mineral density, biochemistry and bone metabolism in elderly patients with cerebral infarction and osteoporosis. Methods Ninety-eight patients with limb paralysis and osteoporosis after acute cerebral infarction were randomly divided into two groups: treatment group (n = 49) and control group (n = 49). The control group was treated with calcium and the treatment group was treated with zoledronic acid and calcium for 6 months. The bone mineral density (BMD) of femoral neck and serum calcium were measured in the two groups after treatment. The bone mineral density of femoral neck and serum calcium were measured. The results showed that the bone mineral density (BMD) of femoral neck and serum calcium, 25(OH)D3, parathyroid hormoid of parathyroid, osteocalcinine OCC1 carboxyl terminal peptide type 1 collagen carboxyl terminal peptide, 尾 -CTXt1 procollagen aminoterminal peptide type 1 procollagen amino terminal peptide1 were detected in both groups. Changes of bone alkaline phosphatase (BALP) level of bone alkaline phosphatase. Adverse drug reactions were recorded in both groups. Results at 6 months after treatment, the bone mineral density of femoral neck in the treatment group was significantly higher than that in the control group (P 0.05), and the bone mineral density of the femoral neck in the treatment group was significantly higher than that in the control group at 6 months after treatment. In the treatment group, the serum levels of 25(OH)D3 and 尾 -CTX were significantly lower than that of P0.05, but there was no significant difference between the two groups. There was no significant difference in the incidence of adverse drug reactions between the two groups (P 0.05). Conclusion Zoledronic acid combined with calcium can improve bone mineral density and bone metabolism in elderly patients with cerebral infarction, and can prevent and treat osteoporosis of senile cerebral infarction safely and effectively.
【作者单位】：南阳市第一人民医院骨科;
【分类号】：R580;R743.3

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