摘要
目的探讨经皮射频消融联合帕米磷酸二钠治疗四肢转移性骨肿瘤患者的疗效评估及对疼痛强度数字评分(NRS)和血清底板反应蛋白(SPON1)、甲状旁腺激素相关蛋白(PTHr P)水平的影响。方法选取2016年2月至2018年6月间许昌市立医院收治的120例转移性骨肿瘤患者,采用随机数字表法分为观察组和对照组,每组60例。观察组患者采用帕米磷酸二钠联合经皮射频消融治疗,对照组患者采用帕米磷酸二钠治疗,治疗4周后,比较两组患者的治疗效果、卡氏功能状态(KPS)评分、NRS评分、应激状态、骨代谢状态、血清SPON1和PTHr P水平及不良反应。结果观察组患者治疗有效率为80. 0%,高于对照组的55. 0%,差异有统计学意义(均P <0. 05)。治疗后,两组患者KPS评分上升,NRS评分下降,且观察组患者KPS评分高于对照组,NRS评分低于对照组,差异均有统计学意义(均P <0. 05)。治疗后,两组患者血清缓激肽、P物质、神经肽Y和Bβ-内啡肽均下降,且观察组患者均低于对照组,差异均有统计学意义(均P <0. 05)。治疗后,两组患者碱性磷酸酶、Ⅰ型胶原羧基末端肽、Ⅰ型前胶原羧基端肽和骨钙素水平均下降,且观察组患者均低于对照组,差异均有统计学意义(均P <0. 05)。治疗后,两组患者SPON1和PTHr P阳性率均下降,且观察组患者低于对照组,差异均有统计学意义(均P <0. 05)。治疗中,两组患者均发生神经损伤、血管损伤、脂肪液化及皮肤坏死,但各不良反应发生率比较,差异均无统计学意义(P>0. 05)。结论经皮射频消融联合帕米磷酸二钠治疗四肢转移性骨肿瘤患者,可降低患者的骨代谢水平和应激水平,下调血清SPON1和PTHr P阳性表达,安全性较好,效果显著。
Objective To observe the eficacy of percutaneous radiofrequency ablation combined with pamidronate disodium in the treatment of metastatic bone tumors of extremities and its effect on numerical rating scale(NRS)score and serum SPON1 and parathyroid hormone-related protein(PTHr P)levels.Methods A total of 120 patients with metastatic bone tumors treated at Xuchang Municipal Hospital from February 2016 to June 2018 were randomly divided into an observation group and a control group,with 60 patients in each group.Patients in observation group were treated with pamidronate disodium combined with percutaneous radiofrequency ablation,while patients in control group were treated with pamidronate disodium only.Both groups were treated for 4 weeks.The difference of therapeutic efficacy,Karnofsky performance score(KPS)score,NRS score,stress state,bone metabolism state,serum SPON1,PTHr P level and adverse reactions between the two groups were observed.Results After treatment,the curative efficacy was80.0%in the observation group which was significantly higher than that 55.0%of the control group.The KPS score increased significantly in the two groups,and the NRS score was significantly lower in the observation group than in the control group.The serum BK,SP,NPY,beta-EP,ALP,I CTP,P I CP,BGP,SPON1 and PTHr P positive rates were significantly decreased in the two groups,and the positive rates of the observation group were significantly lower than those of the control group(all P<0.05).There was no significant difference between the two groups in the occurrence of nerve injury,vascular injury,fat liquefaction and skin necrosis(P>0.05).Conclusion Percutaneous radiofrequency ablation combined with pamidronate disodium in the treatment of metastatic bone tumors of extremities can reduce the positive expression levels of serum SPON1 and PTHr P as well as the level of bone metabolism and stress in patients with metastatic bone tumors of extremities,which is safe and effective.
作者
宗宝宪
张军强
许珂
ZONG Bao-xian;ZHANG Jun-qiang;XU Ke(The First Department of Orthopedics,Xuchang Municipal Hospital,Xuchang 461000,China;Department of Radiology,Fifth People's Hospital of Xuchang,Xuchang 461000,China;Department of Orthopedics,Honghui Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710054,China)
出处
《中国肿瘤临床与康复》
2019年第4期412-416,共5页
Chinese Journal of Clinical Oncology and Rehabilitation
基金
国家自然科学基金资助项目(81601877)
关键词
转移性骨肿瘤
经皮射频消融
帕米磷酸二钠
底板反应蛋白
甲状旁腺激素相关蛋白
Metastatic bone tumors
Percutaneous radiofrequency ablation
Pamidronate disodium
Plate reactive protein
Human parathyroid hormone related protein
