唑来膦酸联合碳酸钙D3治疗骨质疏松症的临床研究

目的探讨唑来膦酸联合碳酸钙D3治疗骨质疏松症的临床疗效。方法 2010年1月-2013年9月郑州市第九人民医院收治的骨质疏松症患者120例,随机分为对照组和治疗组,每组60例。对照组口服碳酸钙D3片,1片/次,2次/d。治疗组在对照组基础上静脉滴注唑来膦酸注射液(5 mg以100 m L生理盐水稀释),静脉滴注时间大于15 min,1次/年。两组均连续治疗1年。观察两组的临床疗效,同时比较两组治疗前后骨密度(BMD)值,VAS评分,血钙、磷和碱性磷酸酶(AKP)变化。结果治疗后,对照组和治疗组的总有效率分别为65.0%、96.7%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组患者L1~4 BMD、血钙均较治疗前显著升高,AKP、VAS评分显著降低,同组治疗前后差异有统计学意义(P0.05、0.01);且治疗组的改善程度优于对照组,两组比较差异有统计学意义(P0.05)。结论唑来膦酸联合碳酸钙D3治疗骨质疏松症具有较好的临床疗效,可以缓解患者疼痛,改善和维持BMD水平,且安全性高,值得临床推广应用。

Clinical study on zoledronic acid combined with calcium carbonate D3 in treatment of osteoporosis

Objective To evaluate the clinical efficacy of zoledronic acid combined with calcium carbonate D3 in treatment of osteoporosis. Methods The patients with osteoporosis (120 cases) of Ninth People's Hospital of Zhengzhou City from January 2010 to September 2013 were randomly divided into control and treatment groups, and each group had 60 cases. The patients in the control group were po administered with Calcium Carbonate D3 Tablets, 1 tablet/time, twice daily. The patients in the control group were iv administered with Zoledronic Acid Injection (5 mg diluted with 100 mL physiological saline) more than 15 min, 1 time/year. The patients in two groups were treated for one year. After the treatment, the efficacy was evaluated, and the changes of BMD, VAS score, blood calcium, phosphorus and AKP were compared in two groups. Results The efficacies in the control and treatment groups were 65.0% and 96.7%, respectively, and there were differences between two groups (P< 0.05). After treatment, BMD of L1-4 and blood calcium in treatment group were significantly elevated, while the AKP and VAS score was significantly reduced, and the differences were statistically significant in the same group (P< 0.05, 0.01). Degree of the improvement in the treatment group was better than that in the control group, with significant difference between two groups (P< 0.05). Conclusion Zoledronic acid combined with calcium carbonate D3 has the good clinical effect in treatment of osteoporosis, and can relieve patients' pain, while can improve and maintain the BMD level with high safety, which is worth clinical promotion.