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目的探讨注射用唑来膦酸对骨质疏松性骨折维吾尔族绝经后妇女骨代谢指标的影响。方法将2011年6月—2013年1月新疆维吾尔族自治区人民医院收治的105例骨质疏松性骨折维吾尔族绝经后妇女纳入本随机对照试验,其中对照组50例,给予口服钙尔奇600 mg/d及阿尔法D3 0.25μg/d,治疗时间6个月;治疗组55例,在对照组治疗的基础上予唑来膦酸5 mg,静脉滴注30 min。观察治疗前后两组患者血清骨碱性磷酸酶(BAP)、骨钙素(BGP)、抗酒石酸酸性磷酸酶(TRACP)-5b水平及L2~L4、股骨颈骨密度(BMD)的变化。结果3例患者失访,102例患者获得随访。治疗组与对照组用药前后BAP、BGP水平比较差异无统计学意义(P>0.05);两组用药前TRACP-5b水平比较,差异无统计学意义(P>0.05),但用药后治疗组TRACP-5b水平显著低于对照组(P<0.05);治疗组用药6个月后患者L2~L4、股骨颈BMD均显著高于对照组(P<0.05)。治疗组8例患者注射唑来膦酸后出现发热、头痛及流感样症状,对症治疗后3 d内缓解,未见肾损害、消化道不适、下颌骨坏死等严重不良反应。结论对于骨质疏松性骨折维吾尔族绝经后女性患者,唑来膦酸注射液可能通过抑制破骨细胞活性、阻止骨吸收来发挥作用,能够有效增强患者骨密度,治疗安全有效,值得推广。
Objective To investigate the effect of zoledronic acid for injection on the bone metabolic parameters of postmenopausal women with osteoporotic fracture in Uygur nationality. Methods A total of 105 Uygur women with osteoporotic fracture who were admitted to People’s Hospital of Xinjiang Uygur Autonomous Region from June 2011 to January 2013 were enrolled in this randomized controlled trial. Among them, 50 cases in the control group were given oral calcium 600 mg / d and alpha D3 0.25μg / d, the treatment time of 6 months; the treatment group 55 cases, in the control group based on the treatment of zoledronic acid 5 mg, intravenous infusion of 30 min. The changes of serum BAP, BGP, TRACP-5b and L2 ~ L4 and femoral neck BMD were observed before and after treatment. Results Three patients were lost and 102 patients were followed up. The levels of BAP and BGP in the treatment group and the control group had no significant difference before and after treatment (P> 0.05). There was no significant difference in TRACP-5b levels between the two groups before treatment (P> 0.05) (P <0.05). The levels of L2 ~ L4 and femoral neck BMD in the treatment group after 6 months of treatment were significantly higher than those in the control group (P <0.05). Eight patients in the treatment group experienced fever, headache and flu-like symptoms after injection of zoledronic acid, and were relieved within 3 days after symptomatic treatment. No serious adverse reactions such as kidney damage, digestive tract discomfort, and mandibular necrosis were observed. Conclusion For female patients with osteoporotic fracture in Uyghur postmenopausal women, zoledronic acid injection may play a role in inhibiting bone resorption by inhibiting osteoclast activity, which can effectively enhance the patient’s bone mineral density and is safe and effective.