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| 甲状旁腺激素(1-34)对颈椎退行性椎间盘疾病合并骨质疏松症术后影响的临床疗效 |
| Clinical effect of parathyroid hormone (1-34) on postoperative cervical degenerative disc disease complicated with osteoporosis |
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| DOI：10.3969/j.issn.1006.7108.2019.07.016 |
| 中文关键词: 颈椎退行性椎间盘疾病 骨质疏松 甲状旁腺激素 骨密度 颈前路椎间切除植骨融合术 |
| 英文关键词:cervical degenerative disc disease osteoporosis parathyroid hormone bone mineral density anterior cervical intervertebral resection and bone graft fusion |
| 基金项目:广西壮族自治区卫生厅基金项目（E2013530） |
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| 中文摘要: |
| 目的 探讨甲状旁腺激素(parathyroid hormone，PTH)(1-34)对颈椎退行性椎间盘疾病合并骨质疏松症术后影响的临床疗效。方法 将74例老年颈椎退行性椎间盘疾病合并骨质疏松症患者随机分为治疗组和对照组。两组患者均进行颈前路椎间盘切除植骨融合术治疗，治疗组术后第6天开始每天皮下注射20μg PTH一次，治疗时间为6个月。分别在术前、术后12个月对患者进行视觉模拟疼痛评分(visual analogue score，VAS)及颈椎脊髓功能评分(JOA)评估；治疗前及治疗12个月后检测患者骨密度(bone mineral density，BMD)改变及血清骨特异性碱性磷酸酶(B-ALP)和抗酒石酸酸性磷酸酶-5b(TRACP-5b)水平的变化。结果 术后12个月，两组患者VAS与JOA评分均较术前有显著改善(P＜0.05)，且同一时间段的治疗组患者评分明显优于对照组(P＜0.05)。术后12个月，治疗组患者BMD较治疗前显著改善(P＜0.05)，同时血清B-ALP和TRACP-5b的水平较治疗前均明显上升(P＜0.05)，且均优于对照组(P＜0.05)。术后12个月，治疗组椎间融合率明显高于对照组，且比较差异有统计学意义(P＜0.05）。结论 PTH辅助颈前路椎间盘切除植骨融合术治疗颈椎退行性椎间盘疾病合并骨质疏松症患者疗效显著。 |
| 英文摘要: |
| Objective To investigate the clinical effect of parathyroid hormone (1-34, PTH) on postoperative cervical degenerative disc disease with osteoporosis. Methods 74 elderly patients with cervical degenerative disc disease with osteoporosis were randomly divided into treatment group and control group. All the patients were treated with anterior cervical decompression and interbody fusion. The treatment group was given subcutaneous injection of 20 μg of PTH once a day from six days post-operation, and the treatment time was 6 months. The visual analogue pain score (VAS) and cervical spine function score (JOA) were evaluated before and 12 months after operation. Bone mineral density, bone alkaline phosphatase (BALP) and tartrate resistant acid phosphatase-5b (TRACP-5b) were measured before and 12 months after operation. Results 12 months after operation, the VAS and JOA scores of the two groups were significantly improved (P<0.05), and the scores of the patients in the treatment group were significantly better than those in the control group (P<0.05). 12 months after operation, bone mineral density was significantly improved (P<0.05) and the levels of serum BALP and TRACP-5b were significantly increased (P<0.05) in the treatment group, and were significantly better than those in the control group (P<0.05). The fusion rate of the treatment group was significantly higher than that of the control group at 12 months after operation (P<0.05). Conclusion PTH-assisted cervical anterior discectomy and bone graft fusion had significant effect for the treatment of cervical degenerative disc disease in patients with osteoporosis. |
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