中国骨质疏松杂志

地舒单抗和唑来膦酸用于OVCF经PKP后的疗效对比

Comparison of the efficacy between teriparatide and zoledronic acid in the rehabilitation of osteoporotic vertebral compression fractures after percutaneous balloon kyphoplasty

DOI：10.3969/j.issn.1006-7108.2025.01.008

中文关键词: 地舒单抗双膦酸盐骨质疏松椎体骨折皮球囊扩张椎体后凸成形术

英文关键词:denosumab bisphosphonates osteoporosis vertebral fracture percutaneous kyphoplasty

基金项目:中华国际科学交流基金会检验检测科技专项基金（Z2020LYN008）

作者	单位
陈雪松宋超* 肖国庆高福存韩静美高斌	昆明理工大学附属安宁市第一人民医院疼痛科，云南昆明 650302

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中文摘要:

目的比较地舒单抗和唑来膦酸在骨质疏松性锥体压缩性骨折（osteoporotic vertebral compressive fractures，OVCF）患者经皮球囊扩张椎体后凸成形术（percutaneous kyphoplasty，PKP）后康复中的应用疗效。方法回顾性选择在昆明理工大学附属安宁市第一人民医院2020年1月至2022年12月收治的OVCF患者372例。对照组为术后给予唑来膦酸静脉注射治疗，治疗组术后给予地舒单抗皮下注射治疗。比较两组患者治疗12个月后的骨密度、Cobb角、骨代谢指标、Oswestry功能障碍指数、VAS评分、SF-35评分和新发椎体骨折率。结果两组患者治疗前骨密度、Cobb角、骨代谢指标、Oswestry功能障碍指数、VAS评分和SF-35评分差异均无统计学意义（P＞0.05）。治疗12个月后，两组患者的上述指标均较治疗前相比显著改善（P＜0.05）；另外，治疗组骨密度高于对照组而Cobb角小于对照组（P＜0.05）；骨代谢指标方面，治疗组的BGP和PINP水平提高和ICPT下降幅度大于对照组（P＜0.05）；同时，治疗组VAS评分和ODI评分低于对照组，SF-36评分高于对照组（P＜0.05）；在新发椎体骨折率方面，治疗组明显低于对照组（P＜0.05）。结论 OVCF患者PKP术后应用地舒单抗或唑来膦酸均可以一定程度上改善患者的骨密度和骨代谢水平、缓解疼痛、改善功能和提高生活质量。二者相比，地舒单抗在改善上述指标方面优于唑来膦酸。

英文摘要:

Objective To compare the therapeutic effects between denosumab and zoledronic acid in the rehabilitation of patients with osteoporotic vertebral compressive fractures (OVCF) after percutaneous kyphoplasty (PKP). Methods A total of 372 OVCF patients treated at the First People's Hospital of Anning City, Kunming University of Science and Technology, from January 2020 to December 2022 were retrospectively selected. Patients in the control group received intravenous zoledronic acid after surgery. Patients in the treatment group received subcutaneous denosumab after surgery. Bone mineral density, Cobb’s angle, bone metabolism indicators, Oswestry disability index, VAS score, SF-35 score, and incidence of new vertebral fractures were compared between the two groups after 12 months of treatment. Results There was no statistical difference in bone mineral density, Cobb’s angle, bone metabolism indicators, Oswestry disability index, VAS score, and SF-35 score between the two groups before the treatment (P>0.05). After 12 months of the treatment, all the above indicators in both groups of patients showed significant improvement compared to those before the treatment (P<0.05). After 12 months of the treatment, bone mineral density in the treatment group was higher than that in the control group, and the Cobb angle was smaller than that in the control group (P<0.05). In terms of bone metabolism indicators, the levels of BGP and PINP in the treatment group increased and the level of ICPT decreased more than in the control group, showing significance (P<0.05). VAS score and ODI score in the treatment group were lower than those in the control group, and SF-36 score was higher than that in the control group (P<0.05). New vertebral fracture rate in the treatment group was lower than that in the control group (P<0.05). Conclusion In patients with OVCF, post-PKP treatment with denosumab or zoledronic acid improves bone mineral density and bone metabolism levels, relieves pain, improves function, and enhances quality of life to a certain extent. Denosumab is superior to zoledronic acid in improving the above indicators.

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