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| 唑来膦酸治疗绝经后女性骨质疏松症的临床效果和生活质量调查 |
| Clinical observation of the effect of zoledronic acid in the treatment of postmenopausal osteoporosis |
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| DOI：10.3969/j.issn.1006.7108.2016.05.021 |
| 中文关键词: 唑来膦酸；骨质疏松 绝经后；骨密度；骨转化生化标志物；疼痛指数 |
| 英文关键词:Zoledronic acid Osteoporosis Postmenopausal Bone mineral density Biochemical markers of bone turnover Pain |
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| 中文摘要: |
| 目的 探讨和分析唑来膦酸治疗20例绝经后女性骨疏松症（postmenopausal osteoporosis,PMO)的疗效。方法 回顾性分析2012年9月至2015年1月在我院门诊诊治的PMO患者20例，首次给予唑来膦酸5mg静脉滴注，复查并记录治疗前后骨密度、骨转化标志物、血钙、肾功，以及VAS疼痛指数和健康状况调查问卷（SF-36)评分变化。应用FRAX软件联合骨密度评估20例PMO患者用药前未来10年内主要部位的骨折概率值。结果 治疗6个月后患者腰椎和全髋关节的骨密度（bone mineral density，BMD)有所提高（P >0. 05)，治疗12个月，患者腰椎、全髋和股骨颈的BMD分别较治疗前明显提高（P<0. 05)。 治疗后3个月，血清β-I型胶原交联羧基末端肽（β-CTX)、1型原胶原氨基端前肽（PINP)均显著下降（P <0. 05),治疗6个月和12个月均保持在较低水平，与治疗前比较差异显著（P<0.05)。治疗前后血钙、肾功能无明显变化（P>0,05)。治疗后VAS得分明显增髙，疼痛指数大有改善，与治疗前比较差异有统计学意义（P<0. 05),治疗后2周VAS指数已有明显的下降，比较差异有统计学意义（P <0.01)。应用FRAX软件联合骨密度评估20例PMO患者用药后未来10年内主要部位的骨折概 率值。治疗后的SF-36量表中各维度得分较治疗前明显提高（P<0. 05),生理总评分（physical component summary，PCS)和心理总评分（mental component summary,MCS)得分较治疗前均有不同程度提高（P <0.05)。结论 唑来膦酸治疗绝经后女性骨质疏松症，能有效改善患者的疼痛，增加骨密度，改善骨代谢相关指标。用FRAX评分联合应用骨密度一起评估骨质疏松症干预治疗，且有效地预测未来10年发生主要部位骨质疏松骨折概率,可有效改善PMO患者的生活质量。 |
| 英文摘要: |
| Objective To study the curative effect of zoledronic acid on the treatment of postmenopausal osteoporosis (PMO). Methods Twenty patients with PMO were retrospectively studied from September 2012 to January 2015. The patients received 5 mg of zoledronic acid intravenously. The changes of bone mineral density (BMD)，biochemical markers of bone turnover, serum calcium, renal function, VAS pain score, and health survey score (SF-36) were examined and recorded. The fracture probability in the next decade was evaluated using FRAX software and in combination with BMD. Results BMD increased slightly after a 6- month treatment (P>0. 05). BMD increased significantly in the experimental group after 12 months (P <0. 05). The levels of β-?C-terminal crosslink of type I collagen (β-CTx) and amino-terminal propeptide of type I collagen (PINP) decreased significantly at 3 months (P < 0. 05), and remained at low levels at 6 and 12 months, showing significant difference compared with those before the treatment (P<0. 05). There were no obvious changes in the levels of serum calcium and renal function (P >0.05). The VAS improved after the treatment significantly (P < 0. 05). The VAS scores declined more rapidly after 2-week treatment (P< 0. 05). FRAX software was used to evaluate the fracture probability in the next decade in combination with BMD. The SF-36 analysis showed that the scores of PCS and MCS improved after the treatment (P< 0.05). Conclusion Treatment with zoledronic acid can effectively relieve pain in patients with the PMO, increase BMD, and improve bone metabolism related indicators. FRAX combined with BMD can effectively evaluate the treatment of PMO and the fracture probability in the next decade, and improve the quality of life in PMO patients. |
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