骨化三醇联合唑来膦酸预防椎体成形术后临近椎体骨折的临床研究

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摘要目的探讨骨化三醇联合唑来膦酸预防椎体成形术（PKP）后临近椎体骨折的临床效果。方法选取2012年2月～2014年6月我院收治的256例胸腰椎压缩性骨折老年患者，PKP术后根据是否自愿应用骨化三醇联合唑来膦酸分为试验组（113例）和对照组（143例）。对照组给予单纯钙剂，试验组在给予钙剂、骨化三醇的基础上采用连续唑来膦酸治疗。所有患者分别于用药前后第3年进行骨密度、椎体高度、局部Cob角测量，并统计两组再骨折数量。结果试验组用药后第3年的骨密度＞治疗前，差异有统计学意义（P＜0.05）。试验组用药前后的椎体高度、Cob角比较，差异无统计学意义（P＞0.05）。对照组用药前后骨密度比较，差异有统计学意义（P＜0.05）。对照组用药后椎体高度低于用药前，Cob角＞用药前，差异有统计学意义（P＜0.05）。试验组用药后的骨密度、椎体高度＞对照组用药后，Cob角＜对照组用药后，差异有统计学意义（P＜0.05）。试验组有1例患者出现临近椎体的骨折，对照组有11例出现临近椎体的骨折。结论持续足量应用骨化三醇联合唑来膦酸可以强化老年胸腰椎脆性骨折椎体后凸成形术后临近椎骨密度，预防其发生骨折，提高远期临床疗效。

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	孙敬华
	阮文礼
	王文辉

关键词 ：椎体成形术, 骨化三醇, 唑来膦酸, 临近椎体

Abstract：Objective To investigate the clinical effect of Calcitriol combined with Zoledronic Acid in the prevention of adjacent vertebral fracture after vertebroplasty.Methods From February 2012 to June 2014,256 elderly patients with thoracolumbar vertebral compression fracture were divided into experimental group(n=113)and control group(n=143)according to whether they were willing to use Calcitriol combined with Zoledronic Acid or not after PKP surgery.In the control group,only calcium supplement was used,while in the experimental group,on the basis of the control group,Calcitriol combinedwithcontinuousZoledronicAcidwasadded.Bone mineral density(BMD),vertebral height,and local Cobb angle were measured before medication and the third year after medication in all patients.The number of refracture was calculated in the two groups.Results In the experimental group,the BMD in the third year after medication was significantly higher than that before treatment(P＜0.05).There was no significant difference in the height of vertebral body or Cob angle before and after medication(P＞0.05).The BMD of the control group before and after treatment was displayed a significant difference(P＜0.05).The height of vertebral body in control group was shorter than that before medication，and the Cob angle was larger compared with prior treatment，which were in great differences(P＜0.05).Compared with the control group after medication,the BMD was better and the vertebral height was larger in the experimental group after therapy,after medication,the Cob angle was small than that in the control group (P＜0.05).In the experimental group,there was 1 case occurred with adjacent vertebral fracture,but 11 cases in the control group.Conclusion Combination of Calcitriol and Zoledronic Acid in continuous sufficient doses can strengthen the adjacent vertebral BMD in the elderly patients with brittle fracture of thoracolumbar spine after PKP surgery,prevent fracture,and improve the long-term clinical effect.

Key words： Vertebroplasty Calcitriol Zoledronic Acid Adjacent vertebra

引用本文:

孙敬华;阮文礼;王文辉. 骨化三醇联合唑来膦酸预防椎体成形术后临近椎体骨折的临床研究[J]. 中国当代医药, 2018, 25(9): 49-52.
SUN Jing-hua;RUAN Wen-li;WANG Wen-hui. Clinical study of Calcitriol combined with Zoledronic Acid in the prevention of adjacent vertebral fracture after vertebroplasty. 中国当代医药, 2018, 25(9): 49-52.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2018/V25/I9/49

[1]	Kim YY，Rhyu KW.Recompression of vertebral body after balloon kyphoplasty for osteoporotic vertebral compression fracture[J].Eur Spine J，2010，19（11）：1907-1912.
[2]	贾小林，谭祖键，杨阜滨，等.椎体后凸成形术与邻近椎体继发骨折的关系[J].中国矫形外科杂志，2012，2（20）：101-102.
[3]	Belkoff SM，Mathis JM，Fenton DC，et al.An ex vivo biomechanical evaluation of an inflatable bone tamp used in the treatment of compression fracture[J].Spine，2001，26（2）：151-156.
[4]	刘忠厚.骨质疏松学[M].北京：科学出版社，1998：142.
[5]	张相伟，孙建民，崔新刚，等.骨质疏松椎体压缩性骨折患者脊柱矢状面的失平衡[J].中国组织工程研究，2014，18（26）：4224-4228.
[6]	Aquarius R，Homminga J，Verdonschot N，et al.The fracture risk of adjacent vertebrae is increased by the changed loading direction after a wedge fracture[J]Spine，2011，36（6）：408-412.
[7]	Pluskiewicz W，Adamczyk P，Franek E，et al.Ten-year probability of osteoporotic fracture in 2012 Polish womenassessed by FRAX and nomogram by Nguyen et al.-Conformity between methods and their clinical utility[J].Bone，2010，46（6）：1661-1667.
[8]	赵杰，袁义，蒋国强.骨质疏松性椎体骨折PKP治疗后相邻椎体再发骨折的原因分析及治疗策略[J].浙江创伤外科，2015，20（2）：338-339.
[9]	张斌，尚永.经皮椎体后凸成形术后继发邻近椎体骨折的危险因素分析[J].临床骨科杂志，2014，17（3）：249-252.
[10]	贾璞，唐海.骨水泥强化术后椎体再骨折的相关因素研究进展[J].中华骨质疏松和骨矿盐疾病杂志，2013，6（1）：83-87.
[12]	HayashiY.Bone diseases with Pain Osgood-Schlatter's disease[J].Clin Calcium，2008，18（1）：103-108.
[11]	Bliemel C，Oberkircher L，Buecking B，et al.Higher incidence of new vertebral fractures following percutaneous vertebroplasty and kyphoplasty-fact or fiction?[J].Acta Orthop Belg，2012，78（2）：220-229.
[13]	Mudano AS，Bian J，Cope JU，et al.Vertebroplasty and kyphoplasty are associated with an increased risk of secondary vertebral compression fractures：a population-based cohort study[J].Osteoporos Int，2009，20（5）：819-826.
[14]	Aquarius R，Homminga J，Hosman AJ，et al.Prophylacticvertebroplasty can decrease the fracture risk of adjacent vertebrae： an in vitro cadaveric study[J].Med Eng Phys，2014，36（7）：944-948.
[15]	Trout AT，Kallmes DF，Kaufmann TJ.New fractures after vertebroplasty：adjacent fractures occur significantly sooner[J].AJNR Am J Neuroradiol，2006，27（1）：217-223.
[16]	费琦，王炳强，杨雍，等计算机模拟椎体成形对临近节段力学影响的有限元分析[J].中国组织工程研究，2011，15（26）：4751-4762.
[17]	Nancollas GH，Tang R，Phipps RJ，et al.Novel insights into actions of bisphosphonates on bone：differences in interactions with hydroxyapatite[J].Bone，2006，38（5）：617-627.
[18]	Bouza C，López-Cuadrado T，Almendro N，et al.Safety of balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures in Europe：a meta-analysis of randomized controlled trials[J].Eur Spine J，2015，24（4）：715-723.
[19]	Harrop JS，Prpa B，Reinhardt MK，et al.Primary and secondary osteoporosis′incidence of subsequent vertebral compression fractures after kyphoplasty[J].Spine，2004，29（19）：2120-2125.