唑来膦酸与鲑鱼降钙素治疗PKP术后骨质疏松症的疗效比较

目的比较唑来膦酸与鲑鱼降钙素治疗经皮椎体后凸成形术(PKP)术后骨质疏松症的疗效。方法选择郑州大学第二附属医院102例骨质疏松性椎体压缩骨折患者,随机分为唑来膦酸组(n=52)和鲑鱼降钙素组(n=50)。唑来膦酸组接受PKP手术和唑来膦酸治疗,鲑鱼降钙素组接受PKP手术和鲑鱼降钙素治疗。比较两组患者术前及术后椎体骨密度(BMD)T评分、视觉模拟疼痛量表(VAS)评分、Oswestry功能障碍指数问卷表(ODI)评分、椎体高度、相邻椎体再骨折的发生率及相关并发症。结果两组患者术后椎体BMD T评分均比术前增高,且在术后6、12、24个月唑来膦酸组高于鲑鱼降钙素组,差异有统计学意义(P<0.05)。两组患者术后的VAS评分、ODI评分均比术前改善,且在治疗后1、3、6个月鲑鱼降钙素组优于唑来膦酸组,差异有统计学意义(P<0.05)。两组患者术后的椎体高度均较术前有明显恢复,差异有统计学意义(P<0.05),两组之间差异无统计学意义(P>0.05)。治疗期间,两组之间相邻椎体再骨折的发生率差异无统计学意义(P>0.05),其他相关并发症差异无统计学意义(P>0.05)。结论PKP术后的骨质疏松症患者应用唑来膦酸的抗骨质疏松治疗效果更好,鲑鱼降钙素的镇痛效果更好。

Comparison of zoledronic acid and salmon calcitonin in treatment of osteoporosis after PKP

Objective To compare the therapeutic effects of zoledronic acid and salmon calcitonin on osteoporosis after percutaneous kyphoplasty(PKP).Methods One hundred and two patients with osteoporotic vertebral compression fractures were selected in the Second Affiliated Hospital of Zhengzhou University and were randomly divided into zoledronic acid group(n=52)and salmon calcitonin group(n=50).The zoledronic acid group receiving PKP plus zoledronic acid treatment and the salmon calcitonin group receiving PKP plus salmon calcitonin treatment.The vertebral Bone Mineral Density(BMD)T score,Visual Analogue Scale(VAS)scores,Oswestry Disability Index(ODI)score,vertebral height,incidence of adjacent vertebral refractures and related complications were compared between the two groups.Results Compared with those before operation,the vertebral BMD T scores were higher after operation in both of the two groups.The vertebral BMD T scores in the zoledronic acid group 6,12,24 months after operation were significantly higher than those in the salmon calcitonin group(P<0.05).Compared with those before operation,the VAS scores and ODI scores were improved after operation in both of the two groups.The improvements of the salmon calcitonin group 1,3,6 months after treatment were better than those of the zoledronic acid group(P<0.05).The postoperative vertebral height in the two groups recovered significantly(P<0.05),however,there was no significant difference between the two groups(P>0.05).During the treatment period,there were no significant differences in the incidence rates of adjacent vertebral refractures and the other related complications between the two groups(P>0.05).Conclusion Zoledronic acid has better anti-osteoporosis effect and salmon calcitonin has better analgesic effect on patients with osteoporosis after PKP.