唑来膦酸注射液联合降钙素治疗75例老年骨质疏松患者的疗效及对血清IL-6、TNF-α水平的影响

高艳红　　哈海枫　　陈小军　　蔡艳丽

[摘要] 目的 探討唑来膦酸注射液联合降钙素治疗老年骨质疏松患者的临床疗效及其对血清IL-6、TNF-α水平的影响。 方法 选取2018年1月至2019年1月我院收治的149例患者，将其随机分为观察组（n=75）和对照组（n=74）。对照组采用降钙素治疗，观察组在此基础上联合唑来膦酸注射液治疗。观察比较两组临床疗效、腰椎密度、VAS评分及血清IL-6、TNF-α水平。 结果 观察组显效48例（64.00%）、有效22例（29.33%）、无效5例（6.67%），整体临床疗效优于对照组，差异有统计学意义（P<0.05）; 观察组临床有效率为93.33%，明显高于对照组的75.68%，差异有统计学意义（P<0.05）。治疗后，两组腰椎密度较治疗前升高，腰背部VAS评分较治疗前降低，差异有统计学意义（P<0.05）;且与对照组相比，观察组腰椎密度明显升高、腰背部VAS评分明显降低，差异有统计学意义（P<0.05）。治疗后两组IL-6、TNF-α水平较治疗前明显下降，差异有统计学意义（P<0.05），且观察组IL-6 、TNF-α水平均显著低于对照组，差异有统计学意义（P<0.05）。 结论 唑来膦酸注射液联合降钙素治疗对老年骨质疏松临床疗效显著，可有效改善患者骨痛症状，增加骨量，提高骨密度，降低炎症因子水平，值得推广应用。

[关键词] 唑来膦酸;降钙素;老年骨质疏松;骨密度;IL-6

[中图分类号] R589.5;R969          [文献标识码] B          [文章编号] 1673-9701（2021）13-0042-04

Efficacy of zoledronic acid injection combined with calcitonin in the treatment of 75 elderly patients with osteoporosis and its effect on serum IL-6 and TNF-α levels

GAO Yanhong   HA Haifeng   CHEN Xiaojun   CAI Yanli

Department of Endocrinology， Qinghai Traffic Hospital， Xi′ning   810000， China

[Abstract] Objective To investigate the clinical efficacy of zoledronic acid injection combined with calcitonin in the treatment of elderly patients with osteoporosis and its effect on serum IL-6 and TNF-α levels. Methods A total of 149 patients admitted to our hospital from January 2018 to January 2019 were selected and randomly divided into the observation group （n=75） and the control group （n=74）. The control group was treated with calcitonin， and the observation group was treated with zoledronic acid injection on this basis. The clinical efficacy， lumbar bone mineral density， VAS score， and serum IL-6 and TNF-α levels between the two groups were observed and compared. Results In the observation group， 48 cases were markedly effective（64.00%）， 22 cases were effective （29.33%）， and 5 cases were ineffective （6.67%）. The overall clinical efficacy in the observation group was better than that in the control group，with significant difference（P<0.05）. The clinical effect rate in the observation group was 93.33%， which was significantly higher than that in the control group （75.68%）， with significant difference（P<0.05）. After treatment， the density of the lumbar spine between the two groups increased more obviously than that before treatment， and the VAS score of the lumber and back decreased more obviously than that before treatment， with significant difference（P<0.05）. Compared with the control group， the density of the lumbar spine in the observation group was higher than that in the control group， and the VAS score of the lumber and back in the observation group was lower than that in the control group， with significant difference（P<0.05）. After the treatment， the levels of IL-6 and TNF-α between the two groups decreased more obviously than those before the treatment， with significant difference（P<0.05）， and the levels of IL-6 and TNF-α in the observation group were significantly lower than those in the control group， with significant difference（P<0.05）. Conclusion Zoledronic acid injection combined with calcitonin has a significant clinical effect on elderly osteoporosis. It can effectively improve the symptoms of bone pain， increase bone mass， increase bone density， and reduce the level of inflammatory factors. It is worthy of popularization and application.

[Key words] Zoledronic acid; Calcitonin; Senile osteoporosis; Bone density; IL-6

骨质疏松症是骨科常见的容易发生骨折的骨骼系统疾病，是指机体由于各种疾病所引起的骨密度及骨质量下降，骨微结构破坏，脆性增加，骨折风险增加[1]。骨质疏松症好发于老年人群，内分泌疾病、结缔组织疾病、慢性肾脏疾病及神经肌肉系统疾病等多因素均可引起骨质疏松症的发生[2]。近年来，随着我国人口老龄化趋势不断加重，老年骨质疏松的发病率呈逐年上升趋势，成为人类较为严重的公共健康问题[3]。患者以疼痛、骨折、身长缩短及脊柱变形等为主要临床表现，严重者活动受限，生活不能自理甚至致残，影响生活质量[4]。

老年骨质疏松的治疗，以药物保守治疗为主。维生素D、降钙素是临床治疗老年骨质疏松症的常用药物，但单纯使用临床效果欠佳，骨痛缓解作用较为局限，也不能有效防治骨量流失[5]。因此，选择合适治疗方案，对提高疗效具有重要临床意义，治疗应从单一药物向联合用药转变。……