活性维生素D3配合唑来膦酸治疗老年原发性骨质疏松的疗效及对MMP-13、TIMP-1的影响

目的探讨活性维生素D3配合唑来膦酸治疗老年原发性骨质疏松(POP)的临床疗效。方法选取2017年1月至2018年1月收治的老年POP患者106例为观察对象,随机分为观察组和对照组各53例,两组均调整生活方式,补充钙剂,对照组给予唑来膦酸,观察组在对照组基础上加用活性维生素D3(骨化三醇),对两组疗效、骨密度(BMD)、基质金属蛋白酶-13(MMP-13)、基质金属蛋白酶抑制剂-1(TIMP-1)、不良反应进行观察。结果观察组治疗总有效率为96.23%,与对照组84.91%比较,明显较高(P<0.05);两组治疗前腰椎L1-4、髋部、Wards三角区BMD无明显差异(P>0.05),观察组治疗1年上述部位BMD提高较同期对照组明显(P<0.05);两组治疗前MMP-13、TIMP-1无明显差异(P>0.05),观察组治疗1年MMP-13和TIMP-1改善较同期对照组明显(P<0.05);观察组不良反应发生率为9.43%,与对照组7.55%比较无明显差异(P>0.05)。结论活性维生素D3配合唑来膦酸治疗老年POP疗效满意,可提高患者骨密度,改善MMP-13和TIMP-1,安全性佳,值得推广。

Efficacy of active vitamin D3 combined with zoledronic acid in treatment of elderly primary osteoporosis and its effects on MMP-13 and TIMP-1

【Objective】To investigate the clinical efficacy of active vitamin D3 combined with zoledronic acid in the treatment of elderly primary osteoporosis(POP).【Methods】A total of 106 elderly patients with POP admitted from January 2017 to January 2018 were selected as observation objects.They were randomly divided into observation group and control group,53 cases in each group.The two groups adjusted their lifestyle and supplemented calcium.The control group was given zoledronic acid.The observation group was given active vitamin D3(calcitriol)on the basis of the control group.The curative effect,bone mineral density(BMD),matrix metalloproteinase-13(MMP-13),tissue inhibitor of metalloprotease-1(TIMP-1)and adverse reactions of the two groups were observed.【Results】The total effective rate of the observation group was 96.23%,which was significantly higher than that of the control group(84.91%)(P<0.05).There was no significant difference in BMD of lumbar L1-4,hip and Wards triangle between the two groups before treatment(P>0.05).After one year of treatment,BMD in the above parts of the observation group was significantly higher than that of the control group in the same period(P<0.05).There was no significant difference in MMP-13 and TIMP-1 between the two groups before treatment(P>0.05).After one year of treatment,the improvement of MMP-13 and TIMP-1 in the observation group was more obvious than that of the control group in the same period(P<0.05).The adverse reaction rate in the observation group was 9.43%,which was not significantly different from that in the control group(7.55%)(P>0.05).【Conclusion】Active vitamin D3 combined with zoledronic acid is effective in the treatment of POP in the elderly.It can improve bone mineral density,MMP-13 and TIMP-1.It is safe and worth popularizing.