唑来膦酸联合甲状旁腺激素对椎体压缩性骨折术后影响的临床研究

发布时间：2019-03-13 13:28

【摘要】：目的探讨唑来膦酸(ZA)联合甲状旁腺激素(PTH)结合经皮椎体成形术(PVP)治疗老年骨质疏松椎体压缩性骨折的疗效及对患者骨密度、骨代谢的影响。方法 95例老年压缩性骨折患者随机分为对照组组和治疗组。两组患者均接受PVP手术治疗,治疗组在术后接受ZA联合PTH治疗。分别在治疗前后6个疗程评定两组患者视觉模拟疼痛评分(VAS)及Oswestry功能障碍指数评分(ODI);治疗前后6个疗程检测患者骨密度及骨钙素(BGP)和β-胶原降解产物(β-Cross Laps);观察治疗组药品不良反应发生情况。结果治疗后6个疗程两组患者VAS与ODI评分均较治疗前有明显改善(P0.05),且治疗组患者评分明显低于对照组(P0.05)。治疗后6个疗程,治疗组患者骨密度较术前显著改善(P0.05),血清BGP和β-Cross Laps较治疗前有显著改变(P0.05),且均明显优于对照组(P0.05);而对照组治疗前后上述指标无明显变(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 PTH联合ZA结合PVP治疗老年骨质疏松椎体压缩性骨折疗效较好,能增加患者骨密度,降低血清BAP和CTX水平,值得推广。
[Abstract]:Objective to investigate the efficacy of zoledronic acid (ZA) combined with parathyroid hormone (PTH) combined with percutaneous vertebroplasty (PVP) in the treatment of osteoporotic vertebral compression fractures in the elderly and its effect on bone mineral density and bone metabolism. Methods 95 elderly patients with compression fracture were randomly divided into control group and treatment group. The patients in both groups were treated with PVP operation, and the patients in the treatment group were treated with ZA combined with PTH after operation. Visual analogue pain score (VAS) and Oswestry dysfunction Index score (ODI);) in two groups were evaluated before and after 6 courses of treatment. Bone mineral density (BMD), osteocalcin (BGP) and 尾-collagen degradation products (尾-Cross Laps);) were measured before and after treatment. Results after 6 courses of treatment, the scores of VAS and ODI in the two groups were significantly improved (P0.05), and the scores of the patients in the treatment group were significantly lower than those in the control group (P0.05). After 6 courses of treatment, the bone mineral density (BMD) of the treatment group was significantly improved (P0.05), the serum BGP and 尾-Cross Laps were significantly changed compared with the pre-treatment (P0.05), and both of them were significantly better than that of the control group (P0.05). There was no significant change in the above indexes before and after treatment in the control group (P0.05). There was no significant difference in the incidence of adverse drug reactions between the two groups (P0.05). Conclusion PTH combined with ZA combined with PVP is effective in the treatment of osteoporotic vertebral compression fractures in the elderly. It can increase the bone mineral density and decrease the levels of serum BAP and CTX. It is worth popularizing.
【作者单位】：广东省人民医院(广东省医学科学院)/广东省老年医学研究所正骨科;广东省人民医院(广东省医学科学院)/广东省老年医学研究所中医科;广东省人民医院(广东省医学科学院)骨外科;
【分类号】：R687.3

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