摘要
目的观察鲑鱼降钙素联合唑来膦酸治疗老年骨质疏松症的疗效及对骨代谢和骨密度的影响。方法回顾性选取2020年1月—2022年6月福鼎市医院收治的108例老年骨质疏松症患者为研究对象,按治疗方式分为唑来膦酸组(n=54)与加用降钙素组(n=54)。唑来膦酸组给予注射用唑来膦酸浓溶液,加用降钙素组在唑来膦酸组基础上给予鲑鱼降钙素注射液。比较2组临床疗效,治疗前与治疗1年后骨代谢指标[骨碱性磷酸酶(NBAP)、Ⅰ型胶原交联氨基末端肽(NTx)、β-胶原降解产物(β-CTX)、骨钙素(BGP)]、骨密度、视觉模拟评分法(VAS)评分、骨标志物{25羟基维生素D[25(OH)D]、Ⅰ型前胶原氨基端前肽(PⅠNP)},不良反应。结果加用降钙素组总有效率高于唑来膦酸组(98.15%vs.81.48%,χ^(2)=8.199,P=0.004)。治疗1年后,2组NBAP、NTx、BGP水平高于治疗前,β-CTX水平及VAS评分低于治疗前,股骨颈、胸椎骨密度大于治疗前,且加用降钙素组各指标优于唑来膦酸组(P<0.05或P<0.01);2组PⅠNP水平低于治疗前,加用降钙素组25(OH)D水平高于治疗前,且加用降钙素组降低/升高幅度大于唑来膦酸组(P<0.01)。唑来膦酸组与加用降钙素组不良反应总发生率比较,差异无统计学意义(9.26%vs.3.70%,χ^(2)=0.611,P=0.434)。结论老年骨质疏松症患者经鲑鱼降钙素联合唑来膦酸治疗的疗效显著,该治疗方案可更有效地改善患者骨代谢,增加骨密度,促进骨转换,减轻疼痛,且安全性较高。
Objective To observe the clinical effect of salmon calcitonin combined with zoledronic acid for senile osteoporosis and the impact on bone metabolism and bone density.Methods A total of 108 cases of senile osteoporosis patients were selected from January 2020 to June 2022 in Fuding Hospital,and they were divided into the group A(n=54)and the group B(n=54)by treatment method.Patients of the group A were given zoledronic acid concentrated solution for injection,and patients of the group B were given salmon calcitonin injection based on group A.Clinical effect,bone metabolism indexes(NBAP,NTx,β-CTX,BGP),bone density,VAS score,bone markers[25(OH)D,PⅠNP]before and after 1 year of treatment,incidence of adverse reactions were compared between the two groups.Results Total effective rate of the group B was higher than that of the group A(98.15%vs.81.48%,χ^(2)=8.199,P=0.004).After 1 year of treatment,levels of NBAP,NTx,BGP of the two groups were higher than those before treatment,β-CTX level and VAS score were lower than those before treatment,bone density of femoral neck and thoracic vertebra were larger than those before treatment,and the group B were better than those of the group A(P<0.05 or P<0.01);PⅠNP level in the two groups was lower than that before treatment,25(OH)D level of the group B was higher than that before treatment,and the indexes of the group B were better than those of the group A(P<0.01).There was no significant difference of the incidence of adverse reactions between the group A and the group B(9.26%vs.3.70%,χ^(2)=0.611,P=0.434).Conclusion As for senile osteoporosis patients,salmon calcitonin combined with zoledronic acid treatment have an exact clinical effect,and it can more effectively improve bone metabolism,increase bone density,promote bone turnover,relieve pain,and with higher safety.
作者
刘芳
高传树
许文腾
张学连
LIU Fang;GAO Chuanshu;XU Wenteng;ZHANG Xuelian(Fuding Hospital,Fujian Province,Fuding 355200,China;不详)
出处
《临床合理用药杂志》
2024年第3期30-33,共4页
Chinese Journal of Clinical Rational Drug Use
关键词
老年骨质疏松症
鲑鱼降钙素
唑来膦酸
骨代谢
骨密度
Senile osteoporosis
Salmon calcitonin
Zoledronic acid
Bone metabolism
Bone density
