骨化三醇联合地舒单抗治疗老年原发性骨质疏松症的临床研究

Clinical study of calcitriol combined with denosumab in the treatment of senile primary osteoporosis

摘要:

目的 观察骨化三醇联合地舒单抗治疗老年原发性骨质疏松症的疗效及安全性。方法 回顾性分析2020年1月—2023年2月四川省中西医结合医院收治的152例老年原发性骨质疏松症患者的资料。其中，77例患者采用常规治疗联合骨化三醇治疗（对照组），75例患者采用常规治疗、骨化三醇联合地舒单抗治疗（研究组）。比较两组骨密度、骨代谢标志物、疼痛情况、功能障碍、临床疗效及不良反应。结果 研究组治疗前后腰椎L_2～4、股骨颈和全髋骨密度的差值均高于对照组（P <0.05）。研究组治疗前后Ⅰ型胶原交联C-末端肽、骨钙素N端中分子片段、骨钙素的差值均高于对照组（P <0.05）。研究组治疗前后疼痛视觉模拟评分、Oswestry功能障碍指数评分的差值均高于对照组（P <0.05）。研究组总有效率高于对照组（P <0.05）。两组总不良反应发生率比较，差异无统计学意义（P >0.05）。结论 骨化三醇联合地舒单抗治疗老年原发性骨质疏松症效果显著，可增加患者骨密度，减轻疼痛及功能障碍，改善骨转换指标。

Abstract:

Objective To observe the efficacy and safety of calcitriol combined with denosumab in the treatment of senile primary osteoporosis.Methods The data of 152 elderly patients with primary osteoporosis admitted to the Sichuan Integrated Traditional Chinese and Western Medicine Hospital from January 2020 to February 2023 were retrospectively analyzed. Among them, 77 patients (control group) were treated with conventional therapy combined with calcitriol, and 75 patients (study group) were treated with conventional therapy combined with calcitriol plus denosumab. The bone mineral density, bone turnover markers, pain levels, functional impairment, clinical efficacy, and adverse reactions were compared between the two groups.Results The changes in bone mineral density of the lumbar spine (L₂~L₄), femoral neck, and total hip before and after treatment were significantly greater in the study group compared to the control group (P < 0.05). The changes in levels of C-terminal telopeptide of type I collagen, N-MID osteocalcin, and osteocalcin before and after treatment were all significantly greater in the study group than in the control group (P < 0.05). The differences in Visual Analogue Scale scores and Oswestry Disability Index scores before and after treatment in the study group were higher than those in the control group (P < 0.05). The overall effective rate of the study group was higher than that of the control group (P < 0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (P > 0.05).Conclusion Calcitriol combined with denosumab is effective in the treatment of senile primary osteoporosis by increasing bone mineral density, alleviating pain and functional impairment, and improving bone turnover markers.