唑來磷酸鈉在絕經(jīng)后骨質(zhì)疏松癥患者中的臨床效果及對骨折率的影響研究

王艷麗

【摘要】 目的：探討唑來磷酸鈉在絕經(jīng)后骨質(zhì)疏松癥患者中的臨床效果及對骨折率的影響。方法：選取2016年2月-2017年2月醫(yī)院收治的絕經(jīng)后骨質(zhì)疏松癥患者100例，按照隨機(jī)數(shù)字表法分為對照組和觀察組，各50例。兩組均口服鈣爾奇D片、骨化三醇膠丸治療，對照組聯(lián)合阿侖膦酸鈉治療，觀察組聯(lián)合唑來磷酸鈉治療。采用視覺模擬疼痛評分（VAS）量表對兩組治療前、后疼痛情況進(jìn)行評估，采用雙能X線骨密度測定儀完成腰椎1～4、股骨頸及Wards骨密度（BMD）測定，比較兩組臨床療效及對骨折率的影響。結(jié)果：兩組治療前VAS評分比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）；觀察組治療后1、3、6個(gè)月VAS評分均低于對照組（P<0.05）；兩組治療前腰椎1～4、股骨頸及Wards骨密度水平比較差異均無統(tǒng)計(jì)學(xué)意義（P>0.05）；觀察組治療后6個(gè)月腰椎1～4、股骨頸及Wards骨密度水平均高于對照組（P<0.05）；兩組治療后1個(gè)月骨折發(fā)生率比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05），觀察組治療后3、6個(gè)月骨折發(fā)生率均低于對照組（P<0.05）。結(jié)論：將唑來磷酸鈉用于絕經(jīng)后骨質(zhì)疏松癥患者中效果理想，有助于減輕患者疼痛，改善患者骨密度水平，降低骨折率，值得推廣應(yīng)用。

【關(guān)鍵詞】 唑來磷酸鈉； 絕經(jīng)后骨質(zhì)疏松癥； 阿侖膦酸鈉； 視覺模擬疼痛評分； 雙能X線骨密度測定儀； 骨折率

【Abstract】 Objective：To investigate the clinical effect of Zoledronic Acid in postmenopausal osteoporosis and its effect on fracture rate.Method：100 patients with postmenopausal osteoporosis admitted from February 2016 to February 2017 were randomly divided into the control group and the observation group，50 cases in each group.Two groups were treated with Caltrate D Tablets and Calcitriol Soft Capsules.The control group combined with Alendronate treatment，the observation group combined with Zoledronic Acid treatment，visual analogue scale （VAS） scale to evaluate of two groups before and after treatment pain，the lumbar 1-4，femoral neck and Wards bone mineral density （BMD） were measured by dual energy X-ray absorptiometry，the clinical efficacy and effect on fracture rate were compared between two groups.Result：The VAS score was compared between two groups before treatment，the difference was not statistically significant（P>0.05），the VAS scores in observation group were lower than that of control group for 1 months，3 months and 6 months after treatment（P<0.05），the lumbar 1-4，femoral neck and Wards bone mineral density were compared between two groups before treatment，the difference was not statistically significant（P>0.05），the lumbar 1-4，femoral neck and Wards bone mineral density of the observation group were higher than those of the control group for 1 month，3 months and 6 months after treatment（P<0.05），the incidence of fractures were compared between two groups for 1 month after treatment，the difference was not statistically significant（P>0.05），the incidence of fracture of the observation group were lower than those of the control group for 3 months and 6 months after treatment（P<0.05）.Conclusion：The effect of Zoledronic Acid in postmenopausal osteoporosis patients is satisfactory，which is helpful to alleviate the pain，improve the bone mineral density and reduce the fracture rate.It is worthy of popularization and application.endprint

【Key words】 Zoledronic Acid； Postmenopausal osteoporosis； Alendronate； Visual analogue pain score； Dual energy X-ray Absorptiometry； Fracture rate

First-authors address：Qianjiang Center Hospital，Qianjiang 433100，China

doi：10.3969/j.issn.1674-4985.2017.29.034

骨質(zhì)疏松癥（OP）是臨床上常見的疾病，是一種以骨量低下、骨微結(jié)構(gòu)發(fā)生不同損壞，從而引起骨脆性增加，如果得不到及時(shí)有效的治療，將會增加骨折發(fā)生率[1]?，F(xiàn)代流行學(xué)調(diào)查研究顯示，預(yù)計(jì)到2050年全球PMOP發(fā)病人數(shù)將超過15.55億[2]。絕經(jīng)后骨質(zhì)疏松癥（PMOP）屬于是一種高轉(zhuǎn)換型OP，多發(fā)生在50歲以上婦女中，臨床表現(xiàn)為骨小梁斷裂或變細(xì)、骨質(zhì)變脆，呈海綿狀，發(fā)病后如果得不到及時(shí)有效的治療，將會影響女性健康及生活[3]。常規(guī)方法以阿侖膦酸鈉治療為主，該方法雖然能改善患者骨密度，但是遠(yuǎn)期療效欠佳，治療后骨折發(fā)生率較高，難以達(dá)到預(yù)期的治療效果[4]。研究……