【作者】 周伟；

【导师】 徐耀增；

【作者基本信息】 苏州大学 ， 骨外科学（专业学位）， 2018， 硕士

【摘要】 目的研究唑来膦酸对绝经后骨质疏松症患者假体周围骨密度的影响。方法从2015年11月到2016年4月选取32例符合入组标准的绝经后骨质疏松症患者随机分成对照组(16例,年龄74.4±5.7岁)和治疗组(16例,年龄73.3±6.6岁),进行为期一年的随访研究。于术后1周、3个月、6个月、12个月通过双能X线扫描(DEXA)测定假体周围骨密度值,于术前1周、术后3个月、6个月、12个月通过血清学检查测定相关骨代谢标志物的水平。结果两组患者术后3个月、6个月、12个月与术后1周(基线)相比,Gruen1-7区骨密度均呈不同程度下降。术后6个月对照组在Gruen1、4、6、7区及术后12个月在Gruen1、2、4、6、7区的骨密度丢失明显高于治疗组。术后3个月、6个月、12个月对照组的骨吸收标志物(β-CTX)水平明显高于治疗组,两组的骨形成标志物(TP1NP)水平仅在术后12个月表现出显著差异(对照组高于治疗组),两组的25(OH)D水平在术后3个月、6个月、12个月均无显著差异。结论绝经后骨质疏松症妇女行全髋关节术后使用5mg唑来膦酸能有效预防假体周围的骨密度丢失及改善骨的重建。更多还原

【Abstract】 Objective To investigate the effect of zoledronic acid on periprosthetic bone mineral density(BMD)after primary total hip arthroplasty in females with postmenopausal osteoporosis.Methods From November 2015 to April 2016,32 female patients who met the inclusion criteria were randomized into two groups: a control group and a zoledronic acid group.At 1 week,3,6,and 12 months after operation BMD was obtained through Dual Energy X-ray Absorptiometry(DEXA)and before the operation and at 3,6,and 12 months after the operation levels of bone metabolism markers were obtained by serum examination.Results Loss of BMD was significantly more pronounced in the control group than in the ZOL group in zones 1,4,6,and 7,at 6 months and in zones 1,2,4,6,and 7 at 12 months after the operation.The levels of bone-resorption marker(β-CTX)were significantly lower in the ZOL group than in the control group at 3,6,and 12 months after operation.The differences from baseline in the levels of bone-formation marker(TP1NP)were statistically significant differences only at 12 months after the operation.Conclusion Receiving an intravenous infusion of 5 mg zoledronic acid after THA can effectively reduce periprosthetic BMD loss and improve bone remodeling in females with postmenopausal osteoporosis.更多还原