老年骨质疏松症患者全髋关节置换后应用阿仑膦酸钠维D3

发布时间：2018-07-05 01:36

本文选题：组织工程 + 髋关节　；参考：《中国组织工程研究》2017年15期

【摘要】：背景:老年骨质疏松症患者全髋关节置换相关的不良反应较为多见,尤其是假体周围骨密度降低造成的假体松动,甚至会导致翻修。目的:观察阿仑膦酸钠维D3在老年骨质疏松患者全髋关节置换后的临床疗效及安全性。方法:将老年骨质疏松患者74例随机分为研究组和对照组,每组37例。两组患者均行全髋关节置换,置换后一两周两组均接受钙剂治疗,研究组患者在此基础上给予阿仑膦酸钠维D3(70 mg)口服,每周1次,两组均连续规律用药6个月。结果与结论:(1)骨密度变化:治疗后3,6个月及1年,研究组腰椎及健侧髋部骨密度较治疗前均明显升高(P0.05),且均明显高于对照组(P0.05);(2)无菌性松动的发生率:两组间假体周围骨折及假体无菌性松动的发生率差异无显著性意义(P0.05);(3)血肌酐、血磷及血钙水平:两组患者术前与治疗后3,6个月及1年的血肌酐、血磷及血钙水平均在正常范围内,组间及组内治疗前后对比均差异无显著性意义(P0.05);(4)结果证实:阿仑膦酸钠维D3可有效增加老年骨质疏松患者全髋关节置换后的骨密度,且无明显不良反应,不影响肾功能及钙磷代谢。
[Abstract]:Background: the adverse effects associated with total hip replacement are more common in elderly patients with osteoporosis, especially the loosening of prosthesis due to reduced bone density around the prosthesis and even revision. Objective: to observe the clinical efficacy and safety of alendronate sodium vitamin D 3 in elderly patients with osteoporosis after total hip replacement. Methods: 74 aged patients with osteoporosis were randomly divided into study group and control group with 37 cases in each group. The patients in both groups were treated with calcium one or two weeks after total hip replacement. The patients in the study group were given alendronate (70 mg) orally once a week for 6 months. Results and conclusion: (1) changes of bone mineral density: 3,6 months and 1 year after treatment, The bone mineral density of lumbar vertebrae and hip in the study group was significantly higher than that before treatment (P0.05), and the incidence of aseptic loosening was significantly higher than that of the control group (P0.05); (2). There was no significant difference in the incidence of periprosthetic fracture and aseptic loosening between the two groups (P0.05); (3). Serum phosphorus and calcium levels: the levels of serum creatinine, serum phosphorus and serum calcium in both groups were within normal range before operation and 3, 6 months and 1 year after treatment. There was no significant difference between the two groups before and after treatment (P0.05); (4). The results showed that Alendronate VD3 could effectively increase bone mineral density (BMD) after total hip replacement in aged patients with osteoporosis, and had no significant adverse effects. Renal function and calcium and phosphorus metabolism were not affected.
【作者单位】：广东药科大学附属第一医院正骨科;广州中医药大学;
【基金】：国家自然科学基金(81674000)~~
【分类号】：R580;R687.4

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