摘要
目的比较绝经后骨质疏松症患者在使用唑来膦酸治疗过程中是否发生脆性骨折的临床研究。方法本研究回顾性分析2010年1月至2017年1月于中山大学孙逸仙纪念医院就诊的绝经后骨质疏松症且已行一次及以上唑来膦酸治疗的患者270例。根据使用唑来磷酸治疗过程中是否出现脆性骨折分为脆性骨折组(n=10)及无脆性骨折组(n=260),比较两组既往脆性骨折史、年龄、基线BMI、基线骨密度、ALP、25(OH)_2Vit D。结果 270例患者获得满意随访,随访率100%,平均治疗时间(2.4±0.5)年。与无脆性骨折组相比,脆性骨折组合并既往骨折史的比例更高(x^2=79.286,P<0.05),脆性骨折组患者基线腰椎、股骨颈区域骨密度、T值更低(t=-2.736,t=-2.170,t=-3.030,t=-2.271,P<0.05)。但组间基线BMI、ALP、25(OH)_2Vit D水平无显著性差异。结论绝经后骨质疏松患者在钙、维生素D摄入充分,治疗依从性良好的情况下,使用唑来膦酸进行治疗时,脆性骨折患者合并既往骨折史的比例更高、基线腰椎、股骨颈区域骨密度、T值更低。
Objective To analyze possible factors of fragility fracture during zoledronic acid(ZOL)treatment in postmenopausal osteoporosis patients(PMOP).Methods A retrospective study of270cases that received at least one ZOL treatment after confirmed PMOP from January2010to January2017in Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University were included.All patients were divided into two groups based on the presence of fragility fracture during ZOL treatment,fragility fracture group had10cases and the non-fragility fracture group had260cases.Previous fragility fracture history,age,BMI,bone mineral density(BMD),ALP,25(OH)2VitD at baseline were compared between two groups.Results Fortyeight patients combined with previous fragility fracture history.Ten patients experienced fragility fracture during ZOL treatment.The proportion of the cases combined with previous fragility fracture history in fragility fracture group was significantly higher than that in the control group(c2=79.286,P<0.05).The baseline of BMD and T-score of the fragility fracture group was significantly lower than that of the control group(t=-2.736,t=-2.170,t=-3.030,t=-2.271,P<0.05).While there were no significant difference of age,BMI,ALP,25-hydroxy vitamin D at the baseline between two groups.Conclusion Under the condition of adequate intake of calcium,vitamin D and good compliance,The proportion of the cases combined with previous fragility fracture history in the fragility fracture group was significantly higher than that of the control group.The baseline of BMD and T-score of the fragility fracture group was significantly lower than that of the control group.
作者
刘伟
傅光涛
胡旭民
李长川
李春海
叶艳芳
丁悦
Liu Wei;Fu Guangtao;Hu Xumin;Li Changchuan;Li Chunhai;Ye Yanfang;Ding Yue(Department of Orthopaedics Sun Yat-Sen Memorial Hospital, Sun YatSen University, Guangzhou 510120, China;Department of Clinical trial design, Sun Yat-Sen Memorial Hospital, Sun YatSen University, Guangzhou 510120, China)
出处
《中华老年骨科与康复电子杂志》
2017年第6期351-355,共5页
Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)
基金
广东省公益研究及能力建设重大专项(2014B020212004)
中山大学孙逸仙纪念医院逸仙临床研究培育项目(2014年)
关键词
骨质疏松症
绝经后
唑来膦酸
脆性骨折
Osteoporosis, postmenopausal
Zoledronic acid
Fragility fracture
