阿仑膦酸钠对骨质疏松胸腰椎骨折患者术后相关指标的影响
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篇名: 阿仑膦酸钠对骨质疏松胸腰椎骨折患者术后相关指标的影响
TITLE: Effects of Alendronate Sodium on the Postoperative Indexes in the Osteoporosis Patients with Thoracolumbar Fracture
摘要: 目的:探讨阿仑膦酸钠对骨质疏松胸腰椎骨折患者术后相关指标的影响。方法:选择2018年1-12月核工业四一六医院收治的170例骨质疏松胸腰椎骨折患者,按随机数字表法分为对照组(85例)和观察组(85例)。所有患者均行皮椎体成形术或经皮椎体后凸成形术。术后,对照组患者给予常规对症支持治疗;观察组患者在对照组基础上给予阿仑膦酸钠片70mg,口服,每周1次。两组患者的疗程均为1年。观察两组患者治疗前及治疗1、3、6、12个月后的疼痛视觉模拟(VAS)评分、骨代谢指标[血磷(P)、血钙(Ca)、骨钙素(OST)、骨型碱性磷酸酶(BAP)],骨保护素(OPG)、核因子κB受体活化因子配体(RANKL)含量和细胞因子[肿瘤坏死因子α(TNF-α)、干扰素γ(IFN-γ)、白细胞介素10(IL-10)]水平,并记录不良反应的发生情况。结果:治疗前,两组患者VAS评分、骨代谢指标,OPG、RANKL含量,细胞因子水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者VAS评分均显著低于同组治疗前,且观察组(治疗1、3、6个月后)显著低于对照组同期(P<0.05);观察组患者治疗3、6、12个月后OST、BAP含量,治疗1、3、6、12个月后OPG、RANKL含量和TNF-α、IFN-γ水平均显著低于同组治疗前及对照组同期,治疗3、6、12个月后IL-10水平均显著高于同组治疗前及对照组同期(P<0.05)。两组患者治疗前后P、Ca以及对照组患者治疗前后OST、BAP含量,OPG、RANKL含量,细胞因子水平比较,差异均无统计学意义(P>0.05)。两组患者总不良反应发生率比较,差异无统计学意义(P>0.05)。结论:阿仑膦酸钠可明显缓解骨质疏松胸腰椎骨折患者术后的疼痛程度,改善细胞因子、骨代谢指标,并抑制相关通路的表达,且安全性较好。
ABSTRACT: OBJECTIVE:To investigate the effects of alendronate sodium on postoperative indexes in the osteoporosis patients with thoracolumbar fracture. METHODS :Totally 170 patients with osteoporotic thoracolumbar fracture admitted in 416 Hospital of Nuclear Industry during Jan.-Dec. 2018 were divided into control group (85 cases)and observation group (85 cases)according to random number table . All patients underwent percutaneous vertebroplasty or percutaneous kyphoplasty. After operation ,control group received symptomatic and supportive treatment. Observation group was additionally given Alendronate sodium tablets 70 mg orally,once a week ,on the basis of control group. Treatment course of 2 groups lasted for one year. VAS score ,bone metabolism indexes [serum phosphorus (P), calcium (Ca), osteocalcin (OST), bone alkaline phosphatase (BAP)], contents of osteoprotegerin(OPG)and nuclear factor-κB receptor activator ligand(RANKL),cytokines(TNF-α,IFN-γ,IL-10)levels were observed in 2 groups before and after 1,3,6,12 months of treatment,and ADR were recorded . RESULTS :Before treatment , there was no significant difference in VAS score ,bone metabolism indexes ,contents of OPG and RANKL and cytokines levels between 2 groups (P>0.05). After treatment ,VAS scores of 2 groups were significantly lower than before treatment ,the observation group was significantly lower than the control group after 1,3,6 months of treatment (P<0.05). OST and BAP contents of observation group after 3,6,12 months treatment as well as OPG and RANKL contents ,TNF-α and IFN-γ levels after 1,3,6,12 months of treatment were significantly lower than before treatment and control group at the same period ;IL-10 level was significantly was higher than before treatment and control group at the same period (P<0.05). There was no statistical significance in P or Ca of 2 groups before and after treatment ,OST,BAP,OPG,RANKL contents and cytokines levels of control group before and after treatment (P>0.05). There was no statistical significance in total incidence of ADR between 2 group(P> 0.05). CONCLUSIONS :Alendronate sodium can significantly relieve the pain and improve cytokines ,bone metabolism indexes , and inhibit expression of releated pathways in osteoporosis patients with thoracolumbar fracture ,with good safety.
期刊: 2020年第31卷第18期
作者: 吴伟,赵鑫,刘代忠
AUTHORS: WU Wei ,ZHAO Xin ,LIU Daizhong
关键字: 阿仑膦酸钠;骨质疏松;胸腰椎骨折;术后指标;细胞因子;骨代谢
KEYWORDS: Alendronate sodium ;Osteoporosis;Thoracolumbar fracture ;Postoperative indexes ;Cytokines;Bone metabolism
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