摘要
目的探讨阿仑膦酸钠治疗老年女性骨质疏松性桡骨远端骨折的临床效果及其对骨代谢和骨密度的影响。方法选择老年女性骨质疏松性桡骨远端骨折患者90例，按照随机数字表法分为治疗组和对照组，每组45例，两组均于行外固定支架术后第3天开始口服药物治疗，对照组给予口服维D钙治疗，治疗组给予阿仑膦酸钠联合维D钙治疗，两组疗程均为6个月。检测两组患者治疗前后的骨密度和骨代谢生化指标[骨碱性磷酸酶（BALP）、抗酒石酸盐酸性磷酸酶异构体5b（TRACP-5b）]，评价两组腕关节功能。结果治疗组和对照组治疗前骨密度分别为（0．472±0．157）、（0．519±0．173）g／cm2，差异无统计学意义（P〉0．05）；治疗后分别为（0．893±0．298）、（0．571±0．184）g／cm2，治疗组骨密度显著升高，与治疗前和对照组治疗后比较差异均有统计学意义（P〈0．05）；而对照组治疗前后比较差异无统计学意义（P〉0．05）。治疗组和对照组治疗前BALP、TRACP-Sb水平分别为（53．76±17．92）、（5．61±1．87）U／L和（51．86±17．29）、（5．54±1．85）U／L，差异无统计学意义（P〉0．05）；治疗后分别为（38．04±11．89）、（4．02±1．26）U／L和（47．21±14．75）、（5．64±1．76）U/L，治疗组患者BALP、TRACP-5b水平显著下降，与治疗前和对照组治疗后比较差异均有统计学意义（P〈1．05）；而对照组治疗前后比较差异无统计学意义（P〉0．05）。治疗组患者腕关节功能评估优良率为91．1％（41／45），显著高于对照组的51．1％（23／45），差异有统计学意义X2=17．524，P〈0．01）。结论阿仑膦酸钠具有抑制骨吸收和促进骨形成的作用，并能促进老年女性骨质疏松性桡骨远端骨折患者术后腕关节功能的恢复。
Objective To investigate the clinical effect of alendronate sodium on bone metabolism and bone mineral density （BMD） for treating the elderly female with osteoporotic distal radius fractures. Methods Ninety elderly female with osteoporotic distal radius fractures patients were divided into treatment group and control group with 45 cases each according to the method of random number list. The two groups were given the medication treatment after 3 d of external fixation stenting. The control group was given calcium dimension D and the treatment group was given alendronate sodium and calcium dimension D. The course of treatment was 6 months. Before and after treatment, the BMD and bone metabolism [ bone alkaline phosphatase（BALP）, tartrate-resistant acid phosphatase-5b（TRACP-5b） ] were detected in both groups. The wrist function of two groups was evaluated. Results Before treatment, the level of BMD of treatment group and control group were （0.472 ± 0.157）, （0.519 ± 0.173） g/cm2,there was no significant difference （P 〉 0.05）. After treatment, the level of BMD of treatment group and control group were （0.893 ± 0.298）, （0.571 ± 0.184） g/cm2,the BMD of treatment group after treatment was significantly higher than that before treatment and control group after treatment（P 〈 0.05 ）. The level of BMD of control group after treatment had no significant difference compared with before treatment （P 〉 0.05）. Before treatment, the level of BALP, TRACP-5b of treatment group and control group were （53.76 ± 17.92）, （5.61 ± 1.87） U/L and （51.86 ± 17.29 ）, （5.54 ± 1.85 ） U/L, the level of BALP, TRACP-5b after treatment had significant difference compared with before treatment and control group after treatment （P 〈 0.05）. There was no significant difference in control group before treatment and after treatment （P 〉 0.05 ）. The good rate of rehabilitation of wrist function in treatment group was 91.1%（41/45 ）, significantly higher than that in control group [51.1%（23/45 ）]（ X2 = 17.524,P 〈0.01）. Conclusions The alendronate sodium has a role to suppress bone resorption and increase BMD. It can promote the recovery of wrist function.
出处
《中国医师进修杂志》
2013年第5期13-16,共4页
Chinese Journal of Postgraduates of Medicine
关键词
桡骨骨折
骨质疏松
骨密度
骨代谢
阿仑膦酸钠
Radius fractures
Osteoporosis
Bone density
Bone metabolism
Alendronate sodium
