摘要
目的探讨唑来膦酸钠对经皮穿刺椎体成形术(PVP)后绝经后女性骨质疏松性椎体压缩骨折(OVCF)患者骨密度的影响。方法对2019年1—12月新疆医科大学第六附属医院微创脊柱外科行PVP治疗的绝经后女性OVCF患者64例的临床资料进行回顾性分析。依据术后是否使用唑来膦酸钠治疗将全部患者分为两组:唑来膦酸钠组(34例)患者PVP术后使用唑来膦酸钠治疗,非唑来膦酸钠组(30例)患者PVP术后不使用唑来膦酸钠治疗。对患者术前与术后1 d、3个月、6个月、12个月疼痛视觉模拟评分(VAS)以及术前与术后左侧股骨颈骨密度T值进行组内与组间比较;观察唑来膦酸钠组患者药物不良反应和两组患者新发骨折情况。结果两组患者的年龄、绝经年龄、体质量指数、注入骨水泥量、术前VAS评分、L1~L4椎体骨密度T值和左侧股骨颈骨密度T值的差异均无统计学意义(均P>0.05)。两组患者术后1 d、3个月、6个月、12个月VAS评分的差异均无统计学意义(均P>0.05)。术后12个月,唑来膦酸钠组与非唑来膦酸钠组患者的VAS评分[(1.65±0.48)分,(1.60±0.50)分]均较术前[(7.20±0.88)分,(7.23±0.85)分]有显著改善(均P<0.001),唑来膦酸钠组患者左侧股骨颈骨密度T值(-1.45±0.69)较术前(-2.43±0.56)有显著上升(P<0.001),非唑来膦酸钠组患者左侧股骨颈骨密度T值(-2.81±0.64)较术前(-2.20±0.82)有显著下降(P<0.001)。唑来膦酸钠组6例患者出现流感样症状,3例出现肌疼痛,3~5 d内症状均自行缓解或经对症治疗后缓解。随访期间,唑来膦酸钠组患者未出现严重肝肾功能损伤、恶性心律失常和下颌骨坏死等并发症,两组患者均未出现新发临床骨折。结论唑来膦酸钠治疗可有效提高PVP术后绝经后女性OVCF患者左侧股骨颈骨密度。
Objective To investigate the effects of zoledronate on postoperative bone mineral density in postmenopausal women with osteoporotic vertebral compression fracture(OVCF)treated by percutaneous vertebroplasty(PVP).Methods Clinical data of 64 patients in postmenopausal women with OVCF treated by PVP in the Department of Minimally Invasive Spine Surgery,the Sixth Hospital Affiliated to Xinjiang Medical University in 2019 were analyzed retrospectively.All patients were divided into 2 groups according to whether they were treated with zoledronate after PVP:34 patients teated with zoledronate after PVP were used as the zoledronate group,and 30 patients treated by only PVP were used as the non-zoledronate group.Preoperative and postoperative visual analogue score(VAS)and bone mineral density(BMD)T value of the patients were compared within and between the 2 groups.Adverse effects of zoledronate in the zoledronate group and new fractures in the 2 groups were observed.Results All patients were followed-up for 12 months.There was no statistical difference between the 2 groups in general data such as age,menopausal age,body mass index(BMI),bone cement volume,VAS score,BMD T value of L1-L4 vertebral body and left femoral neck before surgery(all P>0.05).There was no significant difference in VAS scores on the first day,3 months,6 months and 12 months after the PVP between the 2 groups(all P>0.05).The VAS scores at 12 months after surgery of the zoledronate group and non-zoledronate group were all significantly improved than that befor surgery[(1.65±0.48)vs.(7.20±0.88)and(1.60±0.50)vs.(7.23±0.85),respectively;both P<0.001].The BMD T value of the left femoral neck at 12 months after surgery of the zoledronate group was significant higher than that before surgery(-1.45±0.69 vs.-2.43±0.56,P<0.001).The BMD T value of the left femoral neck at 12 months after surgery of the non-zoledronate group was significant lower than that before surgery(-2.81±0.64 vs.-2.2±0.82,P<0.001).In the zoledronate group,6 patients developed flu-like symptoms and 3 patients developed muscle pain,and all the symptoms resolved spontaneously or after symptomatic treatment within 3-5 d.During follow-up,no complications such as severe liver and kidney damage,malignant arrhythmia and osteonecrosis of the jaw were found and there were no new fractures.Conclusion Zoledronate can effectively improve the BMD of left femoral neck at 12 month after surgery in postmenopausal women with OVCF treated by PVP.
作者
李丽
孟祥玉
Li Li;Meng Xiangyu(Department of Minimally Invasive Spine Surgery,the Sixth Hospital Affiliated to Xinjiang Medical University,Urumqi 830001,China)
出处
《骨科临床与研究杂志》
2022年第6期362-366,共5页
Journal Of Clinical Orthopedics And Research
关键词
骨折
压缩性
胸椎
腰椎
骨质疏松性骨折
骨质疏松
绝经后
药物疗法
椎体成形术
骨密度
Fractures,compression
Thoracic vertebrae
Lumbar vertebrae
Osteoporotic fractures
Osteoporosis,postmenopausal
Drug therapy
Vertebroplasty
Bone density
