阿伦膦酸钠治疗23例骨纤维结构不良的临床观察

目的探讨阿伦膦酸钠治疗骨纤维结构不良的临床疗效。方法选取我院骨科2009年7月至2012年7月诊治的骨纤维结构不良患者23例,给予口服阿伦膦酸钠70 mg每周1次维持治疗,连续服用1年以上。观察治疗前及治疗6个月、12个月以后患者疼痛、病变部位X线表现及阻射密度、生化指标（ALP）的变化。结果 23例骨纤维结构不良患者经阿伦膦酸钠治疗后,疼痛症状明显改善：显效18例、有效4例、无效1例,总有效率95.63%。19例患者病变部位X片检查发现病损区密度增高、骨皮质增厚及溶骨区域出现明显钙化沉积并且大小未见继续扩大。2例X片检查发现病损区无任何变化。1例病损区有进行性发展的趋势,总有效率82.64%,骨病损区X线平均阻射密度较前明显升高（P〈0.05）。治疗前后血清ALP明显降低,治疗前ALP为（110.25±3.21）U/L;治疗后为（40.35±3.17）U/L,差异有统计学意义（P〈0.05）。结论阿伦膦酸钠可有效抑制骨吸收,促进骨生成,从而抑制骨纤维结构不良的病情发展。

Clinical observation of 23 cases with fibrous dysplasia treated by alendronate

Objective To explore the effect of alendronate in the treatment of fibrous dysplasia.Methods From July 2009 to July 2012,23 patients with fibrous dysplasia were selected and given oral alendronate 70mg once a week for maintenance treatment,with continuous use for more than 1 year.Before treatment and after treatment of 6 months and 12 months,the change of pain,X-ray of the lesion and biochemical parameters（ALP） were observed.Results After treatment of 23 cases of fibrous dysplasia,the effect of pain relief was marked in 18 cases,effective in 4 cases,invalid in 1case,and the total efficiency was 95.63%.In 19 patients examined by X-ray,the lesion area of cortical bone thickened,bone mineral density increased and osteolytic area significantly calcificated and deposition and its size did not continue to expand.The lesion area did not change in 2 cases by X-ray examination.One case of lesion had the trend of progressive development,and the total effective rate was 82.64%.The average X-ray radiopacity density of the bone lesion area significantly increased（P＆lt;0.05）.Serum ALP significantly reduced after treatment.Pretreatment serum ALP was（110.25±3.21） U/L;post-treatment serum ALP was（40.35±3.17） U / L（P＆lt;0.05）.Conclusion Bisphosphonate drugs can effectively inhibit bone resorption and promote bone formation,thus they inhibit the fibrous dysplasia progress.