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| 唑来膦酸联合甲状旁腺激素对椎体压缩性骨折术后影 响的临床研究 |
| Clinical observation on the effect of zoledronic acid combined with parathyroid hormone on osteoporotic compression fractures in the elderly after operation |
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| DOI：10.3969/j.issn.1006-7108.2017.05.019 |
| 中文关键词: 骨质疏松椎体压缩性骨折 经皮椎体成形术 甲状旁腺激素 唑来膦酸 骨密度 骨代谢 |
| 英文关键词:Osteoporotic vertebral compression fracture Percutaneous vertebroplasty Parathyroid hormone Zoledronic acid Bone density Bone metabolism |
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| 中文摘要: |
| 目的 探讨唑来膦酸（ZA)联合甲状旁腺激素（PTH)结合经皮椎体成形术（PVP)治疗老年骨质疏松椎体压缩性骨折的 疗效及对患者骨密度、骨代谢的影响。方法 95例老年压缩性骨折患者随机分为对照组和治疗组。两组患者均接受PVP 手术治疗，治疗组在术后接受ZA联合PTH治疗。分别在治疗前后6个疗程评定两组患者视觉模拟疼痛评分（VAS)及 Oswestry功能障碍指数评分（ODI);治疗前后6个疗程检测患者骨密度及骨钙素（BGP)和β-胶原降解产物（β-CrossLaps);观 察治疗组药品不良反应发生情况。结果 治疗后6个疗程两组患者VAS与ODI评分均较治疗前有明显改善（P <0.05),且 治疗组患者评分明显低于对照组（P <0.05)。治疗后6个疗程，治疗组患者骨密度较术前显著改善（P <0.05)，血清BGP和β-CrossLaps较治疗前有显著改变（P <0.05),且均明显优于对照组（P <0.05);而对照组治疗前后上述指标无明显变（P>0.05）。两组药品不良反应发生率比较，差异无统计学意义（P>0.05)。结论 PTH联合ZA结合PVP治疗老年骨质疏松椎 体压缩性骨折疗效较好,能增加患者骨密度，降低血清BAP和CTX水平，值得推广。 |
| 英文摘要: |
| Objective To discuss the curative effect of zoledronic acid (ZA) combined with parathyroid hormone (PTH) and percutaneous vertebroplasty ( PVP) on osteoporotic vertebral compression fractures in elderly patients and its influence on bone mineral density and bone metabolism. Methods 95 cases of elderly patients with osteoporotic vertebral compression fractures were divided into treatment group and control group at random. Patients in the two groups received PVP treatment, and patients in the treatment group were additionally given ZA combined with PTH after operation. The visual analogue scale (VAS) and Oswestry disability index score (ODI) were recorded before and after 6 courses of treatment. Bone mineral density, serum bone gla protein (BGP) and β-collagen degradation products (β-CrossLaps) were assessed before and after 6 courses of treatment. The curative effect, bone density and bone metabolism of patients in the two groups were compared, and the adverse drug reactions were observed as well. Results The VAS and ODI scores of patients in the two groups after 6 courses of treatment were all improved compared with before treatment (P < 0. 05) , and the scores of patients in the treatment group was much lower than those in the control group (P <0. 05). Serum BGP and β-CrossLaps changed significantly compared with before operation (P <0. 05), and all index were better than the control group (P <
0. 05). There were no significant changes in patients in the control group after treatment (P > 0. 05) . There were no significant differences between the two groups on the incidence of adverse drug reactions (P > 0. 05 ). Conclusion The application of ZA combined with PTH and PVP had favorable curative effect on osteoporotic vertebral compression fractures in elderly patients, and could improve bone density, could change the serum levels of BGP and β-CrossLaps, and is suitable for wider clinical application. |
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