摘要
目的探讨地舒单抗与唑来膦酸对恶性肿瘤骨转移患者骨形成标志物及癌痛程度的影响。方法按照随机数字表法将厦门市第三医院2023年1月至2024年10月收治的56例恶性肿瘤骨转移患者分成两组,每组28例。对照组采用唑来膦酸治疗,观察组采用地舒单抗治疗。比较两组临床疗效、骨形成标志物、钙代谢指标、癌痛程度、生活质量及不良反应。结果观察组治疗总有效率为92.86%(26/28),高于对照组的71.43%(20/28);治疗后,观察组碱性磷酸酶水平为(140.43±13.31)U/L,血清磷水平为(1.32±0.33)mmol/L,血清钙水平为(2.51±0.54)mmol/L,均低于对照组的(161.63±16.74)U/L、(1.74±0.43)mmol/L、(2.98±0.65)mmol/L;视觉模拟评分法(VAS)评分为(2.41±0.85)分,低于对照组的(3.67±1.02)分;生活质量综合评定问卷(GQOLI-74)中躯体功能评分为(82.83±3.89)分,心理功能评分为(81.57±3.62)分,社会功能评分为(84.87±4.16)分,物质生活状态评分为(86.82±4.49)分,均高于对照组的(74.17±3.56)分、(72.84±3.33)分、(75.69±3.66)分、(78.73±3.98)分,差异有统计学意义(P<0.05)。观察组不良反应发生率为14.29%(4/28),与对照组的21.43%(6/28)相比,差异无统计学意义(P>0.05)。结论与唑来膦酸相比,地舒单抗在治疗恶性肿瘤骨转移患者时效果更佳,能抑制骨吸收、缓解癌痛、提高生活质量,且未明显增加不良反应,安全可靠,值得临床借鉴。
Objective To investigate the effects of denosumab and zoledronic acid on bone formation markers and cancer pain intensity in patients with malignant tumor bone metastases.Methods A total of 56 patients with malignant tumor bone metastases admitted to The First Affiliated Hospital of Fujian Medical University from January 2023 to October 2024 were divided into two groups using the random number table method,with 28 cases in each group.The control group received zoledronic acid treatment,while the observation group received denosumab treatment.The clinical efficacy,bone formation markers,calcium metabolism indicators,cancer pain intensity,quality of life,and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was 92.86%(26/28),which was higher than 71.43%(20/28)in the control group.After the treatment,the alkaline phosphatase level in the observation group was(140.43±13.31)U/L,the serum phosphorus level was(1.32±0.33)mmol/L,and the serum calcium level was(2.51±0.54)mmol/L,which were lower than those of the control group[(161.63±16.74)U/L,(1.74±0.43)mmol/L,and(2.98±0.65)mmol/L].The Visual Analogue Scale(VAS)score was(2.41±0.85)points,which was lower than that of the control group[(3.67±1.02)points].In the Comprehensive Quality of Life Questionnaire(GQOLI-74),the physical function score was(82.83±3.89)points,the psychological function score was(81.57±3.62)points,the social function score was(84.87±4.16)points,and the material life status score was(86.82±4.49)points in the observation group,which were higher than those of the control group[(74.17±3.56)points,(72.84±3.33)points,(75.69±3.66)points,(78.73±3.98)points],and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 14.29%(4/28),which was not statistically significant compared with[21.43%(6/28)]in the control group(P>0.05).Conclusion Compared with zoledronic acid,denosumab demonstrates superior efficacy in treating malignant tumor bone metastases by inhibiting bone resorption,alleviating cancer pain,and improving quality of life without significantly increasing adverse reactions.It is safe and reliable,making it worthy of clinical reference.
作者
吴冬灵
王杰斌
陈阔
WU Dongling;WANG Jiebin;CHEN Kuo(Department of Orthopedics,Xiamen Third Hospital,Xiamen Fujian 361100,China;Department of Orthopedics,The First Affiliated Hospital of Fujian Medical University,Fuzhou Fujian 350004,China;Department of Orthopedics,Datian County General Hospital,Xiamen Fujian 366100,China)
出处
《天津药学》
2025年第6期682-686,共5页
Tianjin Pharmacy
关键词
恶性肿瘤骨转移
地舒单抗
唑来膦酸
骨形成标志物
癌痛程度
Malignant tumor bone metastases
Denosumab
Zoledronic acid
Bone formation markers
Cancer pain intensity
