摘要
目的:探讨绝经后骨质疏松(PMO)应用唑来膦酸注射液联合碳酸钙D3片治疗的临床效果。方法:选取2015年2月至2017年2月124例PMO患者,采用随机数字表法将这124例患者随机分成观察组(n=62)与对照组(n=62)。对照组口服碳酸钙D3片,观察组在此基础上加用唑来膦酸注射液治疗。所有患者均治疗12个月,对比两组临床疗效,治疗前后各部位骨密度(BMD)值和腰背部、下肢疼痛视觉模拟评分法(VAS)评分及相关生化指标[白介素(IL)-6、骨碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶(TRACP)-5b、尿钙/肌酐比值(U-Ca/Cr)]变化,不良反应发生情况。结果:治疗12个月后,观察组总有效率为93.5%(58/62)明显高于对照组[80.6%(50/62),P<0.05]。与治疗前对比,两组治疗后各部位(股骨颈、全髋、Wards三角区、腰椎L2～4) BMD值均显著增加(P<0.05);且观察组升高更显著(P<0.05)。两组治疗后腰背部、下肢疼痛VAS评分及血清IL-6、BALP、TRACP-5b浓度和尿中U-Ca/Cr值较治疗前均显著减低(P <0.05),且观察组下降更显著(P <0.05)。观察组不良反应率为9.7%(6/62)较对照组[4.8%(3/62)]差异无统计学意义(P>0.05)。结论:PMO应用唑来膦酸注射液联合碳酸钙D3片治疗可有效改善患者症状,增强骨质量,纠正骨重建失衡,疗效显著,安全性高。
Objective:To explore clinical effect of zoledronic acid injection combined with calcium carbonate D 3 tablet in the treatment of postmenopausal osteoporosis(PMO).Methods:124 patients with PMO admitted to our hospital from February 2015 to February 2017 were randomly divided into observation group(n=62)and control group(n=62).The patients in the control group were given oral calcium carbonate D 3 tablets and the patients in the observation group were given oral calcium carbonate D 3 combined with zoledronic acid injection.All patients were treated for 12 months.The clinical effects bone mineral density(BMD),visual analogue scale(VAS),the change of creatinine ratio(U-Ca/Cr)]before and after treatment and the incidence of adverse reactions were compared between the two groups.Results:After 12 months of treatment,the total effective rate of the observation group was 93.5%(58/62)significantly higher than that of the control group[80.6%(50/62),P<0.05].Compared with before treatment,the BMD value of each position(femoral neck,total hip,Wards triangle,lumbar L2~4)in the two groups increased significantly after treatment(P<0.05),and the BMD value in the observation group increased more significantly(P<0.05).After treatment,the VAS score,serum IL-6,BALP,TRACP-5b concentration and urinary U-Ca/Cr value of the two groups were significantly lower than those before treatment(P<0.05),and the observation group decreased more significantly(P<0.05).The adverse reaction rate of the observation group was 9.7%(6/62)compared with the control group[4.8%(3/62)].There was no significant difference(P>0.05).Conclusion:Zoledronic acid injection combined with calcium carbonate D 3 tablets can effectively improve the symptoms of patients with PMO,and enhance bone quality,correct the imbalance of bone remodeling.It has the significant curative effect and high safety.
作者
马辉平
MA Huiping(Shaanxi Nuclear Industry 215 Hospital,Shaanxi Xianyang 712000,China)
出处
《河北医学》
CAS
2018年第12期2065-2070,共6页
Hebei Medicine
基金
陕西省自然科学基金项目
(编号:2013JM032)
关键词
绝经后骨质疏松
唑来膦酸注射液
碳酸钙D3片
骨质量
骨重建失衡
Postmenopausal osteoporosis
Zoledronic acid injection
Calcium carbonate D 3 tablet
Bone mass
Bone remodeling imbalance
