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目的分析静脉用唑来膦酸治疗女性绝经后骨质疏松患者引起的急性发热反应及其相关因素。方法回顾性分析我科2010年6月至2012年4月使用静脉用唑来膦酸5mg治疗的绝经后骨质疏松患者共63人。观察急性期发热出现比例。按是否出现发热症状分为发热组与无发热组。比较两组患者年龄、静脉用唑来膦酸治疗前骨质疏松严重程度、甲状旁腺激素、血清钙差异,及治疗前使用抗骨质疏松药物差异。结果 63例患者中共观察到21例发热,占33.3%。71%(15/21)的患者治疗当天出现发热,于患者均为次日出现发热。66.7%(14/21)的患者发热持续1天,5例发热持续2天,发热时平均体温(38.8±0.5)℃。发热组与无发热组比较,发热组治疗前甲状旁腺激素水平显著高于无发热组(P值<0.05);骨质疏松严重程度、血清钙两组无显著差异。结论绝经后骨质疏松患者静脉用唑来膦酸治疗时出现急性期发热反应并不少见,但均为一过性。治疗前PTH水平与发热相关。
Objective To analyze the acute febrile response induced by intravenous zoledronic acid in women with postmenopausal osteoporosis and its related factors. Methods A total of 63 postmenopausal osteoporosis patients treated with intravenous 5 mg zoledronic acid in our department from June 2010 to April 2012 were retrospectively analyzed. Observe the proportion of fever appears in acute phase. According to whether the symptoms of fever were divided into fever group and no fever group. The differences in the severity of osteoporosis, parathyroid hormone, serum calcium, and anti-osteoporosis medication before treatment were compared between the two groups in terms of age, vein zoledronic acid treatment. Results A total of 21 cases of fever were observed in 63 patients, accounting for 33.3%. 71% (15/21) of the patients had fever on the day of treatment, and fever occurred on the next day in all patients. 66.7% (14/21) patients sustained fever for 1 day, 5 cases sustained fever for 2 days and average body temperature (38.8 ± 0.5) ° C during fever. Compared with no fever group, the level of parathyroid hormone in fever group was significantly higher than that in non-fever group (P <0.05). There was no significant difference in the severity of osteoporosis and serum calcium between the two groups. Conclusion It is not uncommon for postmenopausal osteoporosis patients to have acute exacerbation of fever in the vein treated with zoledronic acid, all of which are transient. Pretreatment PTH levels correlated with fever.