CAJ | 학술논문

目的：探讨注射用唑来膦酸对骨质疏松性骨折维吾尔族绝经后妇女骨代谢指标的影响。方法将2011年6月-2013年1月新疆维吾尔族自治区人民医院收治的105例骨质疏松性骨折维吾尔族绝经后妇女纳入本随机对照试验，其中对照组50例，给予口服钙尔奇600 mg/d及阿尔法D30.25μg/d，治疗时间6个月；治疗组55例，在对照组治疗的基础上予唑来膦酸5 mg，静脉滴注30 min。观察治疗前后两组患者血清骨碱性磷酸酶（BAP）、骨钙素（BGP）、抗酒石酸酸性磷酸酶（TRACP）-5b水平及L2～L4、股骨颈骨密度（BMD）的变化。结果3例患者失访，102例患者获得随访。治疗组与对照组用药前后BAP、BGP水平比较差异无统计学意义（P＞0.05）；两组用药前TRACP-5b水平比较，差异无统计学意义（P＞0.05），但用药后治疗组TRACP-5b水平显著低于对照组（P＜0.05）；治疗组用药6个月后患者L2～L4、股骨颈BMD均显著高于对照组（P＜0.05）。治疗组8例患者注射唑来膦酸后出现发热、头痛及流感样症状，对症治疗后3d内缓解，未见肾损害、消化道不适、下颌骨坏死等严重不良反应。结论对于骨质疏松性骨折维吾尔族绝经后女性患者，唑来膦酸注射液可能通过抑制破骨细胞活性、阻止骨吸收来发挥作用，能够有效增强患者骨密度，治疗安全有效，值得推广。
목적：탐토주사용서래련산대골질소송성골절유오이족절경후부녀골대사지표적영향。방법장2011년6월-2013년1월신강유오이족자치구인민의원수치적105례골질소송성골절유오이족절경후부녀납입본수궤대조시험，기중대조조50례，급여구복개이기600 mg/d급아이법D30.25μg/d，치료시간6개월；치료조55례，재대조조치료적기출상여서래련산5 mg，정맥적주30 min。관찰치료전후량조환자혈청골감성린산매（BAP）、골개소（BGP）、항주석산산성린산매（TRACP）-5b수평급L2～L4、고골경골밀도（BMD）적변화。결과3례환자실방，102례환자획득수방。치료조여대조조용약전후BAP、BGP수평비교차이무통계학의의（P＞0.05）；량조용약전TRACP-5b수평비교，차이무통계학의의（P＞0.05），단용약후치료조TRACP-5b수평현저저우대조조（P＜0.05）；치료조용약6개월후환자L2～L4、고골경BMD균현저고우대조조（P＜0.05）。치료조8례환자주사서래련산후출현발열、두통급류감양증상，대증치료후3d내완해，미견신손해、소화도불괄、하합골배사등엄중불량반응。결론대우골질소송성골절유오이족절경후녀성환자，서래련산주사액가능통과억제파골세포활성、조지골흡수래발휘작용，능구유효증강환자골밀도，치료안전유효，치득추엄。
Objective To explore the effect of injection of zoledronic acid on bone metabolism indicators for osteoporotic fractures in postmenopausal Uygur women. Methods Total of 105 postmenopausal Uygur women with osteoporotic fractures treated from June 2011 to January 2013 in Xinjiang Uygur Autonomous Region People's Hospital were selected. Patients were randomly divided into treatment group (n = 55) and control group (n = 50). In control group, patients were given oral calcium 600 mg/d and alpha D3 0.25 μg/d during 6 months' treatment; In treatment group, patients were given zoledronic acid 5 mg, 30 min, intravenous drip in addition of the treatment in control group. Serum levels of bone metabolism indicators such as bone alkaline phosphatase (BAP), osteocalcin (bone gla protein, BGP) and tartrate resistant acid phosphatase (TRACP)-5b, as well as bone mineral density (BMD) examined from L2-L4 and femoral neck were observed and compared between 2 groups. Results Three patients in treatment group dropped-out, and 102 patients were followed up. Before and after the treatment, difference of BAP, BGP concentration between two groups had no statistical significance (P >0.05). Before the treament, there was no statistical difference of TRACP-5b level between two groups (P >0.05), however, after the treatment, serum level of TRACP-5b in treatment group was lower than that in control group (P<0.05). After 6 months' treatment, BMD level in treatment group was higher than that in control group (P <0.05). In treatment group, 8 patients got fever, headache and influenza-like symptoms, then released in 3 d after symptomatic treatment; No serious adverse reactions such as renal damage, gastrointestinal discomfort, jaw osteonecrosis were found. Conclusion For osteoporotic fractures in postmenopausal Uygur women, zoledronic acid injection is an effective, safe and worthy method which may increase BMD by inhibiting osteoclast activity and prohibiting bone absorption.