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| 强化抗骨质疏松方案治疗老年急性脑梗死偏瘫伴骨质疏松症的临床研究 |
| Clinical study of intensive anti-osteoporosis program in the treatment of elderly patients with acute cerebral infarction combined with osteoporosis |
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| DOI：10.3969/j.issn.1006-7108.2019.10.020 |
| 中文关键词: 碳酸钙D3 唑来膦酸 急性脑梗死 偏瘫 骨质疏松 |
| 英文关键词:calcium carbonate D3 zoledronic acid acute cerebral infarction osteoporosis |
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| 中文摘要: |
| 目的 探讨强化抗骨质疏松方案对急性脑梗死偏瘫伴骨质疏松症老年患者骨密度值、骨代谢转化指标及不良反应的影响。方法 研究对象选取我院2015年10月至2017年10月收治的急性脑梗死偏瘫伴骨质疏松症老年患者共192例，以随机数字表法分为A组（64例），B组（64例）及C组（64例），分别采用碳酸钙D3单用、唑来膦酸单用及两者联用治疗；比较3组患者治疗前后VAS评分、骨密度值、骨代谢生化指标、骨转换指标水平及不良反应发生率。结果 C组患者治疗后VAS评分显著低于A组、B组及治疗前（P＜0.05）；C组患者治疗后腰椎和股骨颈骨密度值均显著高于A组、B组及治疗前（P＜0.05）；3组患者治疗前后血钙和血磷水平比较差异无显著性（P＞0.05）；C组患者治疗后25（OH）D3、PTH及OC水平均显著优于A组、B组及治疗前（P＜0.05）；C组患者治疗后PINP、BALP及β-CTX水平均显著优于A组、B组及治疗前（P＜0.05）；3组患者腹胀、便秘及肌肉疼痛发生率比较差异无显著性（P＞0.05）；B、C组发热发生率显著高于A组（P＜0.05）。结论 强化抗骨质疏松方案用于急性脑梗死偏瘫伴骨质疏松症老年患者可有效缓解肢体疼痛症状，增加骨密度，改善骨代谢生化和骨转换指标，且安全性值得认可。 |
| 英文摘要: |
| Objective To investigate the influence of intensive anti-osteoporosis program on bone mineral density, bone metabolic markers and adverse reactions in elderly patients with acute cerebral infarction combined with osteoporosis. Methods 192 elderly patients with acute cerebral infarction combined with osteoporosis were chosen in the period from October 2015 to October 2017 in our hospital and randomly divided into three groups including A group (64 patients) received calcium carbonate D3, B group (64 patients) received zoledronic acid and C group (64 patients) received calcium carbonate D3 combined with zoledronic acid. The VAS score, bone mineral density, biochemical markers of bone metabolism and bone turnover markers before and after treatment and adverse reaction incidence of the three groups were compared. Results The VAS score after treatment of C group was significantly lower than that of A group, B group and before treatment (P<0.05). The bone mineral density after treatment of C group was significantly higher than that of A group, B group and before treatment (P<0.05). There were no significant differences in the levels of serum Ca and P before and after treatment among the three groups (P>0.05). The after treatment levels of 25(OH)D3, PTH and OC of C group were significantly better than those of A group, B group and before treatment (P<0.05). The after treatment levels of PINP, BALP and β-CTX of C group were significantly better than those of A group, B group and before treatment (P<0.05). There were no significant differences in the incidence of abdominal distension, constipation and muscle pain between the three groups (P>0.05). The incidence of fever in C group was significantly higher than that of A group and B group (P<0.05). Conclusion Intensive anti-osteoporosis program in the treatment of elderly patients with acute cerebral infarction combined with osteoporosis could efficiently relieve pain in limbs, increase bone mineral density, improve biochemical markers of bone metabolism and bone turnover index and the safety is worthy of recognition. |
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