唑来磷酸钠联合骨化三醇治疗原发性骨质疏松症的疗效观察

目的探讨唑来磷酸钠联合骨化三醇治疗骨质疏松症的临床效果。 方法前瞻性收集2012年10月至2017年10月天津市泰达医院收治的203例骨质疏松症患者，采用随机数字表法将其分为唑来磷酸钠组（A组）和唑来磷酸钠联合骨化三醇（B组），A组102例，B组101例，比较两组患者治疗前后的骨密度变化、骨代谢情况、不良反应等情况。 结果203例患者均获得完整随访，随访率100%，随访时间3~5年，平均（3.9±0.5）年。治疗前两组患者的髋部骨密度[A组（0.557±0.052）g/cm³，B组（0.554±0.056）g/cm³]、腰椎骨密度[A组（0.669±0.047）g/cm³，B组（0.670±0.047）g/cm³]无明显差异，治疗后腰椎骨密度水平[A组（0.863±0.023）g/cm³，B组（0.870±0.021）g/cm³]均有显著改善，与治疗前相比，差异均有统计学意义（t=38.661，t=38.152，P<0.05），髋部骨密度水平均有改善[A组（0.720±0.023）g/cm³，B组（0.750±0.044）g/cm³]，与治疗前相比，差异均有统计学意义（t=28.653，t=32.533，P<0.05），治疗后组间差异有统计学意义（t=2.001，t=5.921，P<0.05）；两组患者治疗前血钙指标[A组（2.200±0.059）mmol/L，B组（2.201±0.054）mmol/L]无明显差异，治疗后[A组（2.211±0.060）mmol/L，B组（2.323±0.044）mmol/L]B组血钙变化明显，与A组比较差异有统计学意义（P<0.05）。B组（15.8%）的不良反应发生率低于A组（33.3%），两组患者均无严重药物不良反应发生。 结论唑来磷酸钠联合骨化三醇可提高骨质疏松患者骨密度，改善骨代谢状态，并且降低药物不良反应的发生率。

Observation of curative effect of zolai sodium phosphate combined with trialcohol in treatment of primary osteoporosis

ObjectiveTo investigate the clinical effect of sodium zoledronate combined with calcitriol in the treatment of osteoporosis. MethodsA prospective study of 203 patients with osteoporosis admitted to Tianjin TEDA Hospital from October 2012 to October 2017 was divided into three groups: the sodium zoledronate group (group A) and the combination of sodium zoledronate. Calcitriol (group B), 102 patients in group A and 101 patients in group B. The changes of bone mineral density, bone metabolism and adverse reactions were observed before and after treatment. All the 203 patients had been followed, The rate was 100% and lasted 3-5 years (3.891±0.501 on average). There was no significant difference in bone mineral density of the hip [group A (0.557±0.052) g/cm³, group B (0.554±0.056) g/cm³] and the lumbar vertebrae [group A (0.669±0.047) g/cm³, group B (0.670±0.047) g/cm³] between the two groups before treatment. The bone mineral density of the lumbar vertebrae improved after treatment [group A (0.863±0.023) g/cm³, group B (0.870±0.021) g/cm³], compared with before treatment, the difference was statistically significant (t=38.661, t=38.152, P<0.05). The hip bone mineral density level was improved [group A (0.720±0.023) g/cm³, group B (0.750±0.044) g/cm³], compared with before treatment, the difference was statistically significant (t=28.653, t=32.533, P<0.05). There was significant difference between the two groups after treatment (t=2.001, t=5.921, P<0.05), there was no significant difference in blood calcium index between the two groups before treatment [group A (2.200±0.059) mmol/L, group B (2.201±0.054) mmol/L]. The blood calcium in group B was significantly changed after treatment [group A (2.211±0.060) mmol/L, group B (2.323±0.044) mmol/L], and the difference was statistically significant (P<0.05). The incidence of adverse reactions in group B (15.8%) was lower than that in group A (33.3%), and no serious adverse drug reactions occurred in either group. ConclusionSodium zoledronate combined with calcitriol can increase bone mineral density, improve bone metabolism and reduce the incidence of adverse drug reaction-s in patients with osteoporosis.