The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Department of Diagnostics of Traditional Chinese Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China.
Orthop Surg. 2019 Jun;11(3):380-385. doi: 10.1111/os.12460. Epub 2019 May 6.
To observe the effect of zoledronic acid on the reduction of acute bone loss and fracture rate in elderly postoperative patients with intertrochanteric fracture.
From August 2012 to January 2015, a total of 482 patients with senile osteoporotic femoral intertrochanteric fracture, who accepted proximal femoral intramedullary fixation under anesthesia were analysed. The patients were divided into two groups. Treatment group (353 cases) were treated with 100 mL/5 mg of zoledronic acid injection in 1 week after operation, as well as orally taken 600 mg/d of calcium carbonate and active vitamin D3 400 IU/d. Control group (129 cases) were given the same dose of calcium carbonate and active vitamin D3 orally. Efficacy evaluation were conducted during different periods of medication RESULTS: Compared with pre-medication, indexes of bone metabolism (TARP-5b, CTX) in the treatment group were brought down, especially significantly statistically different after 12 months of medication. The treatment group performed superior to control group in alleviating the pain of back and posture changing (P < 0.05), improving bone density (P < 0.05), depressing re-fracture rate (P < 0.01) after 24 months of medication. In addition, BP, PF and MH dimension scores were demonstrated with statistical significance (P < 0.05).
The application of zoledronic acidin elderly postoperative patients with intertrochanteric fracture can not only relieve acute bone loss, reduce the incidence rate of re-fracture, alleviate osteoporosis pain and the pain from osteoporotic fracture, but also improve bone metabolism and quality of life, which may offer an acceptable clinical opinion.
观察唑来膦酸对老年股骨粗隆间骨折术后患者急性骨丢失和骨折率降低的影响。
2012 年 8 月至 2015 年 1 月，分析了 482 例接受麻醉下股骨近端髓内固定的老年骨质疏松性股骨粗隆间骨折患者。患者分为两组。治疗组（353 例）术后 1 周内给予唑来膦酸注射液 100 mL/5 mg，同时口服碳酸钙 600 mg/d 和活性维生素 D3 400 IU/d。对照组（129 例）给予相同剂量的碳酸钙和活性维生素 D3 口服。在不同的用药期间进行疗效评估。
与用药前相比，治疗组骨代谢指标（TARP-5b、CTX）下降，用药 12 个月后差异有统计学意义。治疗组在缓解腰背疼痛和姿势改变方面（P<0.05）、改善骨密度（P<0.05）、降低再骨折率（P<0.01）方面优于对照组，用药 24 个月后差异有统计学意义。此外，BP、PF 和 MH 维度评分均有统计学意义（P<0.05）。
唑来膦酸在老年股骨粗隆间骨折术后患者中的应用，不仅能缓解急性骨丢失，降低再骨折发生率，缓解骨质疏松性疼痛和骨质疏松性骨折疼痛，还能改善骨代谢和生活质量，为临床提供一种可接受的治疗意见。
