[1]宋会平,张柳.阿仑膦酸钠治疗老年女性骨质疏松性椎体压缩骨折的疗效分析[J].中华老年骨科与康复电子杂志,2017,(06):327-331.[doi:10.3877/cma.j.issn.2096-0263.2017.06.002]
　Song Huiping,Zhang Liu.Efficacy analysis of alendronate in the treatment of osteoporotic vertebral compression fracture in senile women[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(06):327-331.[doi:10.3877/cma.j.issn.2096-0263.2017.06.002]
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阿仑膦酸钠治疗老年女性骨质疏松性椎体压缩骨折的疗效分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2017年06期
页码:
327-331
栏目:
论著
出版日期:
2017-11-27

文章信息/Info

Title:
Efficacy analysis of alendronate in the treatment of osteoporotic vertebral compression fracture in senile women
作者:
宋会平; 张柳
063000 唐山，华北理工大学附属医院骨科
Author(s):
Song Huiping;  Zhang Liu
Department of Orthopedics, the Affiliated Hospital of North China University of Science and Technology, Tangshan 06300, China
关键词:
阿仑膦酸钠;  老年人;  骨质疏松症;  椎体压缩骨折
Keywords:
Alendronate;  Aged;  Osteoporosis;  Vertebral compression fracture
DOI:
10.3877/cma.j.issn.2096-0263.2017.06.002
文献标志码:
A
摘要:
目的 探讨阿仑膦酸钠治疗老年女性骨质疏松性椎体压缩骨折的临床疗效。方法 回顾性分析华北理工大学附属医院骨质疏松门诊 2012年 5月至 2016年 12月期间诊治的骨质疏松性椎体压缩骨折患者 73例，年龄 60～85岁，平均（68±8）岁。均在每日联用骨化三醇（罗盖全）0.25 ug和钙尔奇 D 600 mg的基础上，每周 1次口服阿仑膦酸钠（福善美）70 mg，连续治疗 10～16个月。随访并记录治疗前后骨密度（BMD）及其变化率、疼痛视觉模拟评分（VAS）、Beaujon脊柱功能评分、生化指标检测、影像学评价等方法评估治疗效果，观察再骨折和不良反应情况。结果 73 例患者均获得随访，随访时间为 10～16 个月，平均（13±2）个月，与治疗前相比，腰椎和股骨颈 BMD 值明显增加，差异有统计学意义（t=12.034，t=6.418，P＜0.05）；腰背痛和胸背痛明显改善，VAS 评分显著降低，差异有统计学意义（t=28.055，P＜0.05）；日常生活质量和脊柱功能明显提高，Beaujon功能评分明显改善，差异有统计学意义（t=10.301，P＜0.05）。治疗前后血尿常规、肝肾功能、钙、磷、碱性磷酸酶生化指标检测治疗前后未见明显异常；治疗期间影像学发现有 5例再发椎体骨折，无严重药物不良反应出现。结论 阿仑膦酸钠联合基础补钙措施可有效治疗老年女性严重骨质疏松性椎体压缩骨折，增加骨量，缓解骨痛，改善脊柱功能。
Abstract:
Objective To investigate the clinical efficacy of alendronate in the treatment of osteoporotic vertebral compression fractures in elderly females. Methods A retrospective review was conducted in 73 elderly females with osteoporotic vertebral compression fractures from May 2012 to December 2016. The average age was 68±8 years (60-85 years). All patients took an oral medication of 0.25 ug calcitriol and 600 mg calcium carbonate with Vitamin D3 per day as a basic treatment, in addition with 70 mg alendronate once a week and last for 10- 16 months．Bone mineral density (BMD), visual analogue scale (VAS), Beaujon functional score, imaging analyses and biochemical tests were recorded to evaluate the clinical efficacy before and after alendronate intervention at different time point. The adverse events and fracture occurrence were also observed. Results All 73 patients were followed up for 13±2 months. Compared with that before treatment, BMD of lumbar vertebrae (t=12.034, P<0.05) and femoral necks (t=6.418, P<0.05) were both significantly increased. VAS scores were significantly decreased (t=28.055, P<0.05), while Beaujon functional score was markedly elevated at the endpoint (t=10.301, P<0.05). All biochemical markers including blood and urinary tests, hepatic and renal function, calcium phosphorus and alkaline phosphatase maintained within normal range before and after the treatment. Radiological evaluation found 5 re-fractures of vertebral bodies, no serious adverse effects were found during the treatment. Conclusion Combined with basic calcium supplement, Alendronate can effectively treat osteoporotic vertebral compression fracture, increasing bone mass, relieving skeletal pains and improving spinal function.

参考文献/References:

1 Lindsay R, Silverman SL, Cooper C, et al. Risk of new vertebral fracture in the year following a fracture [J]. JAMA, 2001, 285(3): 320-323.
2 Zampini JM, White AP, Mcguire KJ. Comparison of 5766 vertebral compression fractures treated with or without kyphoplasty [J]. Clin Orthop Relat Res, 2010, 468(7): 1773-1780.
3 宋会平, 张柳. 阿仑膦酸钠治疗老年女性严重骨质疏松症患者的疗效分析 [J]. 中华老年骨科与康复电子杂志, 2016, 2(3): 141-145.
4 Lassale B, Deburge A, Benoist M. Long-term results of the surgical treatment of lumbar stenosis [J]. Rev Rhum Mal Osteoartic, 1985, 52 (1): 27-33.
5 邱贵兴, 裴福兴, 胡侦明, 等. 中国骨质疏松性骨折诊疗指南（骨质疏松性骨折诊断及治疗原则）[J]. 中华骨与关节外科杂志, 2015, 8 (5): 371-374.
6 Warming L, Hassager C, Christiansen C. Changes in bone mineral density with age in men and women: a longitudinal study [J]. Osteoporos Int, 2002, 13(2): 105-112.
7 Old JL, Calvert M. Vertebral compression fractures in the elderly [J]. Am Fam Physician, 2004, 69(1): 111-116.
8 Nevitt MC, Ross PD, Palermo L, et al. Association of prevalent vertebral fractures, bone density, and alendronate treatment with incident vertebral fractures: Effect of number and spinal location of fractures [J]. Bone, 1999, 25(5): 613-619.
9 Staples MP, Howe BM, Ringler MD, et al. New vertebral fractures after vertebroplasty: 2-year results from a randomised controlled trial [J]. Arch Osteoporos, 2015, 10(1): 229.
10 Shah S, Goregaonkar AB. Conservative management of osteoporotic vertebral fractures: a prospective study of thirty patients [J]. Cureus, 2016, 8(3): e542.
11 Park YS, Kim HS. Prevention and treatment of multiple osteoporotic compression fractures. Asian Spine J [J]. 2014, 8(3): 382-390.
12 Schilcher J, Koeppen V, Aspenberg P, et al. Risk of atypical femoral fracture during and after bisphosphonate use [J]. N Engl J Med, 2014, 371(10): 974-976.
13 Borromeo GL, Brand C, Clement JG, et al. A large case- control study reveals a positive association between bisphosphonate use and delayed dental healing and osteonecrosis of the jaw [J]. J Bone Miner Res, 2014, 29(6): 1363-1368.
14 Lin TC, Yang CY, Kao Yang YH, et al. Incidence and risk of osteonecrosis of the jaw among the Taiwan osteoporosis population [J]. Osteoporos Int, 2014, 25(5): 1503-1511.
15 Chiu WY, Chien JY, Yang WS, et al. The risk of osteonecrosis of the jaws in Taiwanese osteoporotic patients treated with oral alendronate or raloxifene [J]. J Clin Endocrinol Metab, 2014, 99(8): 2729-2735.
16 廖二元, 徐苓, 朱汉民, 等. 原发性骨质疏松症干预的疗效监测与评估专家意见 [J]. 中华骨质疏松和骨矿盐疾病杂志, 2015, 8(1): 1-6.

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备注/Memo

备注/Memo:
河北省医学科学研究重点课题计划（20170916）
更新日期/Last Update: 2017-11-24