【摘要】 目的 探讨前瞻性应用唑来膦酸（zoledronic acid,ZOL）早期干预实体瘤骨转移、骨相关事件（skeletalrelated events,SREs）时对血清钙等生化指标的影响。方法 2016年1月至2020年12月入组165例患者，中位年龄52岁。按简单随机方法分为两组，A组55例，男11例，女44例，治疗结束即使用ZOL;B组110例，男34例，女76例，同期治疗结束的、不使用ZOL、定期随访的患者。对两组患者的碱性磷酸酶、血清钙、血清磷及肾功能变化进行比较评价（A组为首次用药前及末次随访后，B组为首次随访及末次随访后）。采用SPSS 19.0软件行统计学分析，计数资料经描述性分析检验正态性分布及方差齐性后，用独立样本t检验比较均值；组间比较采用配对样本t检验。结果 165例患者随访率为99.39%，中位随访时间为37个月。两组的入组情况及病种特征差异无统计学意义（P> 0.05）。两组ALP、Ca²⁺、Pi及BUN、Cr均值比较，差异均无统计学意义（P> 0.05）。组间分析：A组治疗前后血清钙下降（t=3.757,P <0.001），差异有统计学意义，余碱性磷酸酶、血清磷及肾功能变化差异均为统计学意义（P> 0.05）。结论 实体瘤尚未骨转移患者，经使用ZOL早期干预后，血清钙水平下降。ZOL早期干预实体瘤SREs对钙代谢有一定影响。更多还原

【Abstract】 Objective:To investigate the effect of zoledronic acid(zoledronic acid,ZOL)on early intervention of bone metastasis of solid tumor and bone related events(skeletal-related events,SRES)on serum calcium and other biochemical indexes. Methods:From January 2016 to December 2020,165 patients with a median age of 52 years were enrolled.According to the simple random method,55 cases in group A,with 11 males and 44 females,were treated with ZOL at the end of treatment,and 110 cases in group B,with 34 males and 76 females,were treated without ZOL at the end of the same period and followed up regularly. The changes of alkaline phosphatase,serum calcium,serum phosphorus and renal function in the two groups were compared and evaluated(before the first medication and after the last follow-up in group A,and after the first follow-up and the last follow-up in group B). SPSS 19. 0 software was used for statistical analysis. After descriptive analysis was used to test the normal distribution and homogeneity of variance,the mean value was compared with independent sample t-test;Paired sample t-test was used for comparison between groups. Results:The follow-up rate of 165cases was 99. 39%,and the median follow-up time was 37 months. There was no difference in the enrollment and disease characteristics between the two groups(P > 0. 05). There was no significant difference between the two groups(P > 0. 05).Analysis between groups:before and after treatment,serum calcium in group a decreased(t = 3. 757,P < 0. 001),the difference was statistically significant,and there was no difference in the changes of residual alkaline phosphatase,serum phosphorus and renal function. Conclusion:The serum calcium level of patients with solid tumor without bone metastasis decreases after early intervention with ZOL. Early intervention of solid tumor SREs by ZOL has a certain effect on calcium metabolism.更多还原