实用老年医学

实用老年医学 ›› 2024, Vol. 38 ›› Issue (12): 1238-1241.doi: 10.3969/j.issn.1003-9198.2024.12.011

• 临床研究 • 上一篇    下一篇

地舒单抗联合经皮椎体后凸成形术治疗老年女性骨质疏松性椎体压缩骨折的效果观察

黄志鹏, 宋梦颖, 赵小林, 欧阳传炜, 张鹏   

  1. 210024 江苏省南京市,南京医科大学附属老年医院骨科(黄志鹏,赵小林,欧阳传炜,张鹏);
    210002 江苏省南京市,东部战区总医院质量管理科(宋梦颖)
  • 收稿日期:2024-04-08 出版日期:2024-12-20 发布日期:2024-12-19
  • 通讯作者: 张鹏,Email:zhangp4007@163.com

Effect of denosumab combined with percutaneous kyphoplasty in the treatment of osteoporotic vertebral compressed fracture in elderly women

HUANG Zhipeng, SONG Mengying, ZHAO Xiaolin, OUYANG Chuanwei, ZHANG Peng   

  1. Department of Orthopedic, Geriatric Hospital of Nanjing Medical University, Nanjing 210024, China(HUANG Zhipeng, ZHAO Xiaolin, OUYANG Chuanwei, ZHANG Peng);
    Quality Management Department, General Hospital of Eastern Theater Command, Nanjing 210002, China(SONG Mengying)
  • Received:2024-04-08 Online:2024-12-20 Published:2024-12-19
  • Contact: ZHANG Peng, Email: zhangp4007@163.com

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摘要： 目的 观察地舒单抗联合经皮椎体后凸成形术治疗老年女性骨质疏松性椎体压缩骨折(osteoporotic vertebral compressed fracture, OVCF)的效果。方法 选取接受经皮椎体后凸成形术(percutaneous kyphoplasty, PKP)治疗的102例老年女性胸腰椎压缩性骨折病人,根据是否接受地舒单抗治疗分为对照组(n=49)和治疗组(n=53)。对照组予口服碳酸钙D3片及阿法骨化醇软胶囊治疗,治疗组在对照组的基础上加用地舒单抗治疗。于术前和术后3 d、6个月、12个月使用VAS评分及Oswestry功能障碍指数(ODI)评分评价病人的疼痛改善情况及疗效。比较2组病人随访1年内临近椎体再骨折发生率及骨密度的变化。结果 治疗6个月及12个月后,对照组病人的VAS及ODI评分较术后3 d显著增加,治疗组ODI较术后3 d改善,且2组比较,差异有统计学意义(P＜0.05)。治疗12个月后,治疗组骨密度较治疗前明显升高,且高于对照组(P＜0.05)。术后1年内治疗组临近椎体再骨折发生率为5.7%,显著低于对照组的18.4%(P＜0.05)。结论 地舒单抗联合PKP治疗OVCF临床疗效显著,可有效减轻病人的临床症状,增加骨密度,降低术后临近椎体再骨折风险,改善病人远期预后。

关键词: 骨质疏松性椎体压缩骨折, 地舒单抗, 经皮椎体后凸成形术

Abstract: Objective To observe the efficacy of denosumab combined with percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compressed fracture (OVCF) in the elderly women. Methods A total of 102 elderly female patients with thoracolumbar vertebral compressed fracture who underwent PKP were divided into control group and treatment group according to whether they received denosumab treatment. The control group received oral calcium carbonate and vitamin D3 tablets and alfacalcidol soft capsules, while the treatment group received denosumab in addition to the control group’s dosage regimen. The scores of Visual Analogue Scale (VAS)and Oswestry Disability Index (ODI) were used to evaluate pain improvement and the effect of the patients before surgery and 3 days, 6 and 12 months after treatment. The incidence rate of adjacent vertebral refracture and changes in bone mineral density at 1-year followup were compared between the two groups. Results After 6 and 12 months of treatment, VAS and ODI scores of the control group increased, and the ODI scores of the treatment group decreased compared with those 3 days after treatment, and there were significant differences between the two groups (P＜0.05). After 12 months of treatment, the bone mineral density of the treatment group was significantly higher than that before treatment and that of the control group (P＜0.05); The adjacent vertebral refracture rate in the treatment group was significantly lower than that in the control group (P＜0.05). Conclusions Denosumab combined with PKP can prominently improve the clinical efficacy of OVCF treatment, effectively alleviate clinical symptoms, increase bone mineral density, reduce the risk of adjacent vertebral refracture after surgery and improve long-term prognosis of the elderly women patients.

Key words: osteoporotic vertebral compressed fracture, denosumab, percutaneous kyphoplasty

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