中国骨质疏松杂志

甲状旁腺激素联合低频脉冲电磁场治疗老年骨质疏松性股骨粗隆骨折的临床疗效观察

Clinical efficacy of parathyroid hormone combined with low frequency pulsed electromagnetic field on osteoporotic fractures of the femur in elderly patients

DOI：10.3969/j.issn.1006.7108.2018.01.001

中文关键词: 老年骨质疏松粗隆骨折骨密度 PTH 骨代谢指标低频脉冲电磁场

英文关键词:Osteoporotic femoral trochanteric fractures in elderly Bone mineral density Parathyroid hormone Low frequency pulsed electromagnetic field.

基金项目:

作者	单位
弓永顺* 万超徐毅	郑州市中医院，河南郑州 450007

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中文摘要:

目的探索抗骨质疏松药物PTH联合低频脉冲电磁场(LFPEF)辅助治疗老年骨质疏松股骨粗隆骨折效果。方法 2013年7月～2015年4月间收治的老年骨质疏松性股骨粗隆骨折98例，采用随机数字表法将其分为治疗组和对照组，每组49例，两组患者均接受PFNA治疗。对照组术后给予PTH治疗，治疗患者术后给予PTH联合LFPEF治疗，比较两组患者治疗后患者视觉模拟痛疼评分(VAS)、髋关节Harris功能评分、骨折愈合时间、股骨颈及腰椎的骨密度和骨代谢指标的改变。结果术后1个月、3个月、6个月两组患者VAS评分均明显降低，且治疗组患者评分明显低于对照组(P＜0.05)；术后3个月、6个月两组患者的Harris 评分均明显上升，且治疗组患者评分明显高于对照组(P＜0.05)；治疗组骨折愈合的时间明显少于对照组(P＜0.05)；术后6个月两组患者股骨颈及腰椎的骨密度，治疗组患者骨密度较术前显著改善(P＜0.05)。术后6个月，治疗组的BALP和BGP 水平显著上升，而TRACP-5b 和 CTX 水平显著下降，与治疗前和对照组比较均有显著性差异(P＜0.05)；而对照组治疗后 BALP、BGP、TRACP-5b、CTX 水平较治疗前显著增高(P＜0. 05)。结论抗骨质疏松药物联合LFPEF是一种安全有效的辅助治疗老年骨质疏松粗隆骨折方法，值得临床推广。

英文摘要:

Objective To explore the effect of anti-osteoporosis drug PTH combined with low frequency pulsed electromagnetic field (LFPEF) on osteoporotic fractures of the femur in elderly patients. Methods 98 cases of elderly osteoporotic femoral trochanteric fractures were treated from July, 2013 to April, 2015. They were divided into treatment group and control group by random number table method, with 49 cases in each group. Both groups were treated with PFNA. After surgical treatment, the patients in the control group were treated with PTH and the patients in the treatment group were treated with PTH combined with LFPEF. The visual analogue pain scores (VAS), hip function scores (Harris), fracture healing time, and bone mineral density of the femoral neck, lumbar spine, and bone metabolism were compared between the two groups. Results The VAS scores of the two groups significantly decreased at 1 month, 3 months, and 6 months after operation, and the score in the treatment group was significantly lower than that in the control group (P<0.05). The Harris scores in both groups increased significantly at 3 month and 6 months after operation, and the score in the treatment group was significantly higher than that in the control group (P<0.05). The time of fracture healing in the treatment group was significantly less than that in the control group (P<0.05). BMD of the femoral neck and lumbar vertebrae at 6 months after operation, and BMD in the treatment group significantly improved (P<0.05). At 6 months after operation, the levels of BALP and BGP in the treatment group significantly increased, but the levels of TRACP-5b and CTX significantly decreased. The difference was significant compared with the control group and before the treatment (P<0.05). The levels of BALP, BGP, TRACP-5b, and CTX in the control group were significantly higher than those before the treatment (P<0.05). Conclusion Anti-osteoporosis drugs combined with LFPEF is a safe and effective method for the treatment of elderly osteoporosis complicated with femoral trochanteric fractures, and it is worthy of clinical promotion.

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