CAJ | 학술논문

目的：探讨唑来膦酸静脉注射治疗绝经后骨质疏松症出现急性期不良反应（ APR）情况及可能的影响因素。方法分析2012年8月-2013年6月期间我院内分泌科、骨科应用唑来膦酸治疗绝经后骨质疏松症的患者107例，均应用唑来膦酸5mg静脉注射。分为发生APR组[APR（＋）]及未发生APR组[APR（-）]，比较两组之间年龄、BMI、是否曾服用钙片、非甾体类消炎药（NSAIDs）、双膦酸盐等因素与APR的相关性。结果（1）107例患者中总不良反应发生率为83.2％；其中发热78例（72.9％）；肌肉痛51例（47.7％）；发热和胃肠道反应2例（1.9％）；（2） APR（＋）组BMI水平、曾使用双膦酸盐比例低于APR（-）组（P＜0.05），合并骨质疏松性骨折比例高于APR（-）组（P＜0.05）；（3） Logistic回归分析显示BMI和使用双膦酸盐为APR的发生的保护因素（P＜0.05）。结论唑来膦酸（5mg）静脉注射后急性期不良反应较常见，多为一过性。高BMI及曾使用双膦酸盐可减少急性期不良反应发生的风险。
목적：탐토서래련산정맥주사치료절경후골질소송증출현급성기불량반응（ APR）정황급가능적영향인소。방법분석2012년8월-2013년6월기간아원내분비과、골과응용서래련산치료절경후골질소송증적환자107례，균응용서래련산5mg정맥주사。분위발생APR조[APR（＋）]급미발생APR조[APR（-）]，비교량조지간년령、BMI、시부증복용개편、비치체류소염약（NSAIDs）、쌍련산염등인소여APR적상관성。결과（1）107례환자중총불량반응발생솔위83.2％；기중발열78례（72.9％）；기육통51례（47.7％）；발열화위장도반응2례（1.9％）；（2） APR（＋）조BMI수평、증사용쌍련산염비례저우APR（-）조（P＜0.05），합병골질소송성골절비례고우APR（-）조（P＜0.05）；（3） Logistic회귀분석현시BMI화사용쌍련산염위APR적발생적보호인소（P＜0.05）。결론서래련산（5mg）정맥주사후급성기불량반응교상견，다위일과성。고BMI급증사용쌍련산염가감소급성기불량반응발생적풍험。
Objective To investigate the characteristics of the acute phase response ( APR ) after intravenous zoledronic acid treatment for postmenopausal osteoporosis and the potential factors of the APR development.Methods A total of 107 patients with postmenopausal osteoporosis , who were treated in the Department of Endocrinology and the Department of Orthopedics from August 2012 to June 2013, were selected.All the patients were treated with 5mg zoledronic acid intravenously , and they were divided into with APR group [APR ( +)] or without APR group [APR ( -)].The difference of age, BMI, calcium intake, NSAIDs intake, and previous treatment with bisphosphonate was compared between the two groups .And the correlation analysis was also performed . Results The total rate of APR in 107 patients was 83.2%.Among which, 78 patients experienced fever (72.9%);51 patients had musculoskeletal pain (47.7%);and 2 patients suffered from fever and gastrointestinal reaction (1.9%).BMI and the rate of bisphosphonate history in APR (+) group were lower than those in APR (-) group ( P<0.05 ) , while the rate of osteoporotic fracture in APR (+) group was higher than that in APR (-) group (P<0.05).Logistic regression analysis suggested that BMI and previous treatment with bisphosphonate were protective factors of the development of APR ( P<0.05 ) .Conclusion After intravenous injection of 5mg zoledronic acid, APR occurs frequently, but transiently.Higher BMI and previous treatment with bisphosphonate significantly reduce the risk of APR .