摘要
目的分析鲑鱼降钙素序贯伊班膦酸预防胸腰段骨质疏松性椎体压缩性骨折(OVCFs)术后再骨折的疗效。方法将300例经皮椎体后凸成形术(PKP)后的OVCFs患者随机分组,150例PKP术后使用鲑鱼降钙素序贯伊班膦酸联合钙剂治疗者归为治疗组,150例单纯使用钙剂者归为对照组,比较两组疗效。结果治疗后,两组疼痛评分均随治疗时间延长逐渐降低(P<0.05),且治疗组各时间点下降幅度大于对照组(P<0.05);治疗后,两组胸腰段、髋部、股骨颈骨密度随时间延长明显上升,甲状旁腺素(PTH)、血钙、血磷水平均显著上升,尿钙/肌酐值(Ca/Cr)和尿脱氧吡啶啉/肌酐(DPD/Cr)水平显著下降,且治疗组的变化幅度大于对照组,差异有统计学意义(P<0.05);治疗12个月后,两组闭目单足站立时间、强化Romberg测试时间均长于治疗6个月后(P<0.05),且组间差异显著(P<0.05);治疗组跌倒率10%,再次骨折率0%,对照组为24.67%和10.67%,差异有统计学意义(P<0.05)。结论 OVCFs患者行PKP术后预防性使用鲑鱼降钙素序贯伊班膦酸治疗,可明显改患者骨性疼痛症状、提升骨密度、改善骨代谢指标和增强患者平衡能力,预防跌倒和术后再骨折效果显著,值得临床推荐。
Objective To analyze the effect of salmon calcitonin sequential ibandronate in theprevention of refracture after surgery of thoracolumbar osteoporotic vertebral compression fracturesOVCFs）. Methods A total of 300 patints with OVCFs after percutaneous kyphoplasty （PKP） wereandomly divided into two groups, with 150 cases in each group. Patients treated with salmoncalcitonin sequential ibandronate combined with calcium after PKP were included into the treatmentgroup, while patients treated with calcium alone were included into the control group. The curativeeffect was compared between the two groups. Results After treatment, the pain scores of the twogroups decreased gradually over time （P〈0.05）, and the decreased range was greater in the treatmentgroup than the control group at different time points （P〈0.05）. After treatment, the thoracolumbar, hipand femoral neck bone mineral density （BMD） of the two groups increased significantly over time, theevels of parathyroid hormone （PTH）, serum calcium and blood phosphorus increased significantly inhe two groups, while the levels of urinary calcium/creatinine （Ca/Cr） and deoxypyridinoline/creatinineDPD/Cr） decreased significantly, and the changes of above indicators were more significant in thereatment group than those in the control group （P〈0.05）. After 12 months of treatment, the standingime with eyes closed on one foot and time of strengthening Romberg test of the two groups were longerhan those after 6 months of treatment （P〈0.05）, and there were significant differences between the twogroups （P〈0.05）. The incidence rates of falls and refracture in the treatment group were 10% and 0%,those in the control group were 24.67% and 10.67% , respectively （P 〈0.05）. Conclusion Thepreventive application of salmon calcitonin sequential ibandronate in patients with OVCFs after PKPcan significantly relieve bone pain symptoms, improve BMD, improve bone metabolism indicators andenhance the balance ability of patients. The effect is significant in preventing falls and postoperativerefracture.
作者
武刚
刘利
刘振武
WU Gang;LIU Li;LIU Zhen-wu(Handan Central Hospital,Handan,Hebei,05601,China.)
出处
《颈腰痛杂志》
2018年第6期698-701,共4页
The Journal of Cervicodynia and Lumbodynia
