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目的:分析依替膦酸二钠对老年性骨质疏松症的疗效及安全性。方法:以2013年1月至2016年6月在西安交通大学附属三二0一医院门诊及住院部接受治疗的老年骨质疏松症患者60例为研究对象,将60例患者按照接受治疗时间顺序分为观察组和对照组,每组30例。对照组给予钙尔奇D片治疗,观察组在对照组的基础之上加用依替膦酸二钠,两组治疗时间12个月。比较两组的疗效及安全性。结果:治疗后,观察组的股骨颈骨密度和腰椎骨密度均治疗前升高(P<0.05),对照组治疗前与治疗后比较,差异无统计学意义(P 0.05);观察组治疗后的股骨颈和腰椎骨密度均高于对照组(P<0.05)。治疗后,观察组的骨密度治疗显效率和总有效率均高于对照组(P<0.05)。治疗后,观察组和对照组的视觉模拟评分法(VAS)评分均较治疗前降低(P<0.05),观察组的VAS评分低于对照组,观察组的腰背疼痛治疗显效率及总有效率均高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组Trap-5b水平较治疗前下降(P<0.05),观察组的Balp和对照组的Trap-5b和Balp水平较治疗前有下降趋势,但无差异无统计学意义(P0.05);观察组治疗后的Trap-5b水平均低于对照组(P<0.05)。两组的不良反应发生率比较,观察组高于对照组(P<0.05)。结论:依替膦酸二钠可有效改善老年性骨质疏松症患者的骨密度及骨疼痛,有效降低Trap-5b和Balp水平,抑制破骨过程,但不良反应发生率较高,临床需综合评估患者情况合理选择用药。
Objective: To analyze the efficacy and safety of etidronate in senile osteoporosis. Methods: From January 2013 to June 2016, 60 elderly patients with osteoporosis who were treated in the outpatient department and inpatient department of No. 321 Hospital, Xi’an Jiaotong University were enrolled in this study. Sixty patients were randomly divided into treatment time Divided into observation group and control group, 30 cases in each group. The control group was treated with Calcium Acetate D, and the observation group was given etidronate disodium on the basis of the control group. The two groups were treated for 12 months. The curative effect and safety of the two groups were compared. Results: After treatment, the femoral neck BMD and lumbar BMD of the observation group increased before treatment (P <0.05), but there was no significant difference in the control group before and after treatment (P 0.05) The femoral neck and lumbar spine BMD were higher than those in the control group (P <0.05). After treatment, the effective rate and total effective rate of bone mineral density in observation group were higher than those in control group (P <0.05). After treatment, the visual analogue scale (VAS) scores of the observation group and the control group were lower than those before treatment (P <0.05), and VAS scores of the observation group were lower than those of the control group. The effective rate of the treatment of low back pain in the observation group and the total The efficiency is higher than the control group, the difference was statistically significant (P <0.05). After treatment, Trap-5b level in observation group decreased compared with that before treatment (P <0.05). The levels of Trap-5b and Balp in Balp and control group in observation group decreased compared with those before treatment, but there was no significant difference (P> 05). Trap-5b levels in observation group were lower than those in control group (P <0.05). Adverse reactions in both groups were compared, the observation group was higher than the control group (P <0.05). Conclusion: Etidronate disodium can effectively improve the bone mineral density and bone pain in elderly patients with osteoporosis, effectively reduce the levels of Trap-5b and Balp, and inhibit the osteoclast process, but the incidence of adverse reactions is high, and the clinical need to be comprehensive Evaluation of patients with a reasonable choice of medication.