唑来膦酸连续2年治疗绝经后女性骨质疏松临床观察

目的：观察唑来膦酸连续2年治疗绝经后女性骨质疏松的疗效、急性发热反应情况及其相关因素分析。方法回顾性分析我科2010年7月至2013年7月连续2年静脉使用唑来膦酸5mg滴注治疗绝经后女性骨质疏松患者共46人。年龄60～74岁，平均年龄（66．87±6．77）岁。观察每次急性期发热出现比例及每例患者前后2次药物输注后发热出现情况。比较治疗第1年、第2年骨质疏松差异及甲状旁腺激素、血清钙差异。结果46例患者中第1次输注唑来膦酸共观察到20人发热，占43．4％，次年输注唑来膦酸仅1例出现发热，发热组治疗前甲状旁腺激素水平显著高于无发热组（ P＜0．05）。第2次输注前甲状旁腺激素、血清钙较第1年输注前均无显著差异（ P＞0．05），第2次输注前骨密度监测腰椎及全髋T值较第1次有所改善（P＜0．05）。结论绝经后女性骨质疏松患者连续静脉用唑来膦酸治疗对骨密度有改善，首次治疗出现急性期发热反应并不少见，但均为一过性，次年均可耐受。治疗前PTH水平可能与发热反应相关。

The analysis of the postmenopausal osteoporosis women receiving intravenous zoledronic acid in two years

Objective To analyze the curative effect in postmenopausal osteoporosis women receiving intravenous zoledronic acid in two years and identify the related factors.Methods Forty-six postmenopausal patients with osteoporosis were treated with intravenous infusion of 5mg zoledronic acid twice in july 2010 to july 2013.Observe the incidence of acute febrile reaction before each use.Then tested the serum calcium, T degree of Bone mineral density, and parathyroid hormone.Results Acute febrile reaction occurred in 20(43.4%) of the patients for the first time.The next time,we observed only one patient.The patients with fever showed higher parathyroid hormone levels before treatment than those without fever (P<0.05).serum calcium and the degree of parathyroid hormone showed no significant difference Around twice.The bone mineral density of Lumbar and total hip in all the patients had been improved during the treatment.Conclusion The continuous use of intravenous zoledronic acid could improve the living ability in postmenopausal osteoporosis women.Acute febrile reaction was common, but it was transient.The reaction is possibly associated with parathyroid hormone levels before the treatment.