维生素 D 补充对骨质疏松性椎体压缩骨折合并维生素 D 缺乏症患者功能结局的影响。
Effects of vitamin D supplementation on the functional outcome in patients with osteoporotic vertebral compression fracture and vitamin D deficiency.
机构信息
Department of Orthopaedic Surgery, School of Medicine, Daegu Catholic University, Daegu Catholic University Hospital, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu, 42472, Korea.
出版信息
J Orthop Surg Res. 2021 Sep 24;16(1):571. doi: 10.1186/s13018-021-02717-7.
BACKGROUND
In osteoporotic vertebral compression fractures, supplementation using vitamin D preparations and maintenance of blood vitamin D level within the normal range are necessary for proper fracture union, enhancement of muscle strength, and maintenance of body balance. The purpose of this study is to investigate the effects of vitamin D supplementation on blood vitamin D level, pain relief, union time, and functional outcome in patients with osteoporotic vertebral compression fracture and vitamin D deficiency.
METHODS
One hundred thirty patients who were deficient in blood vitamin D level and had osteoporotic vertebral compression fracture were divided into supplementation group and non-supplementation group. Initially, 3 months, 6 months, and 12 months after the injury, radiographs were taken to assess fracture union, and questionnaires were evaluated to evaluate the functional outcome and quality of life.
RESULTS
The mean age of the 130 patients (36 males and 94 females) was 74.75 ± 7.25 years. There were no statistically significant differences in initial severity of low back pain, functional outcome, and quality of life between the insufficient group and the deficient group (all p values were > 0.05). There was no significant time-by-group interaction between the supplementation group and the non-supplementation group (p = 0.194). In terms of SF-36 physical component score, there was no significant time-by-group interaction between the supplementation group and the non-supplementation group (p = 0.934).
CONCLUSIONS
Fracture union was achieved in all patients regardless of serum vitamin D level, and there were significant improvements in severity of low back pain, functional outcome, and quality of life over 12 months in patients with osteoporotic vertebral compression fracture. Short-term vitamin D supplementation of patients with osteoporotic vertebral compression fracture and deficiency of vitamin D did not result in significant differences in fracture union status, functional outcome, and quality of life between the supplementation groups and the non-supplementation groups of patients.
背景
在骨质疏松性椎体压缩性骨折中，补充维生素 D 制剂并将血液维生素 D 水平维持在正常范围内，对于骨折愈合、增强肌肉力量和维持身体平衡是必要的。本研究的目的是探讨维生素 D 补充对骨质疏松性椎体压缩性骨折合并维生素 D 缺乏患者的血液维生素 D 水平、疼痛缓解、愈合时间和功能结局的影响。
方法
将 130 例血液维生素 D 水平缺乏且患有骨质疏松性椎体压缩性骨折的患者分为补充组和非补充组。在受伤后 3 个月、6 个月和 12 个月时，拍摄 X 线片评估骨折愈合情况，并通过问卷调查评估功能结局和生活质量。
结果
130 例患者（男 36 例，女 94 例）的平均年龄为 74.75±7.25 岁。在初始腰痛严重程度、功能结局和生活质量方面，补充组和非补充组之间无统计学差异（p 值均>0.05）。补充组和非补充组之间无显著的时间-分组交互作用（p=0.194）。在 SF-36 生理成分评分方面，补充组和非补充组之间无显著的时间-分组交互作用（p=0.934）。
结论
无论血清维生素 D 水平如何，所有患者均实现了骨折愈合，且在 12 个月时，骨质疏松性椎体压缩性骨折患者的腰痛严重程度、功能结局和生活质量均有显著改善。对骨质疏松性椎体压缩性骨折合并维生素 D 缺乏的患者进行短期维生素 D 补充，在骨折愈合状态、功能结局和生活质量方面，补充组和非补充组之间无显著差异。
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