CAJ | 학술논문

目的：研究老年女性骨质疏松症合并髋关节病患者行全髋关节置换术后急性期内应用唑来膦酸的疗效及安全性。方法选择2009年1月至2010年1月因髋部骨折或股骨头无菌性坏死住院接受全髋关节（非骨水泥型假体）置换术的老年女性患者，根据骨密度（ BMD）检测结果选取骨质疏松症患者148例，随机分为治疗组和对照组，2组患者手术后均接受钙剂和骨化三醇治疗，治疗组于术后1～2周给予唑来膦酸5 mg静脉滴注，以后每年给药1次，连续3年，对照组在治疗组用药同期给予相同体积0.9％氯化钠注射液。每年复查并记录腰椎及健侧髋部骨密度变化，观察术后3年内假体周围骨折及假体无菌性松动的发生情况。结果治疗组连续治疗3年后骨密度较用药前提高，差异有统计学意义（ P＜0.05）；对照组用药前后骨密度差异有统计学意义（ P＜0.05）；术后3年内治疗组发生假体周围骨折及假体无菌性松动的例数均低于对照组。2组用药后不良反应发生率差异有统计学意义（ P＜0.05）。结论骨质疏松患者行关节置换术后急性期内使用唑来膦酸安全有效，可提高骨密度，且可能减少假体周围骨折和假体松动的发生。
목적：연구노년녀성골질소송증합병관관절병환자행전관관절치환술후급성기내응용서래련산적료효급안전성。방법선택2009년1월지2010년1월인관부골절혹고골두무균성배사주원접수전관관절（비골수니형가체）치환술적노년녀성환자，근거골밀도（ BMD）검측결과선취골질소송증환자148례，수궤분위치료조화대조조，2조환자수술후균접수개제화골화삼순치료，치료조우술후1～2주급여서래련산5 mg정맥적주，이후매년급약1차，련속3년，대조조재치료조용약동기급여상동체적0.9％록화납주사액。매년복사병기록요추급건측관부골밀도변화，관찰술후3년내가체주위골절급가체무균성송동적발생정황。결과치료조련속치료3년후골밀도교용약전제고，차이유통계학의의（ P＜0.05）；대조조용약전후골밀도차이유통계학의의（ P＜0.05）；술후3년내치료조발생가체주위골절급가체무균성송동적례수균저우대조조。2조용약후불량반응발생솔차이유통계학의의（ P＜0.05）。결론골질소송환자행관절치환술후급성기내사용서래련산안전유효，가제고골밀도，차가능감소가체주위골절화가체송동적발생。
Objective To analyse the curative effect and security of zoledronic acid on total hip arthroplasty with os -teoporosis .Methods A total of 148 osteoporotic patients with THA were enrolled from 2009 to 2010 .Patients were as-signed into the treatment group (n=95, meanage=68.8 years) receiving Caltrate D and Calcitriol plus zoledronic acid for 36 month and the control group (n=97, meanage=68.1 years) receiving Caltrate D and Calcitriol only .Bone min-eral density ( BMD) was measured by dual-X-ray absorptiometry ( DXA) at lumbar spine and the healthy hip before pre-intervention and after 36 months intervention respectively .The rate of prosthesis loosening and prosthesis adjacent fracture were observed and compared .Results The BMD was improved in treatment group compared with pre-intervention , which was significantly better than control group ( P<0.05 ) .The prosthesis loosening and prosthesis adjacent fracture in treat-ment group was obviously less than control group .The adverse reactions were significantly higher in the treatment group than the control group ( P<0.05 ) .Conclusion Zoledronic acid could significantly improve BMD , reduce the prosthe-sis loosening and prosthesis adjacent fracture .