目的 探討唑來膦酸聯(lián)合碳酸鈣D3治療骨質(zhì)疏松癥的臨床療效。方法 2010年1月-2013年9月鄭州市第九人民醫(yī)院收治的骨質(zhì)疏松癥患者120例,隨機(jī)分為對(duì)照組和治療組,每組60例。對(duì)照組口服碳酸鈣D3片,1片/次,2次/d。治療組在對(duì)照組基礎(chǔ)上靜脈滴注唑來膦酸注射液(5 mg以100 mL生理鹽水稀釋),靜脈滴注時(shí)間大于15 min,1次/年。兩組均連續(xù)治療1年。觀察兩組的臨床療效,同時(shí)比較兩組治療前后骨密度(BMD)值,VAS評(píng)分,血鈣、磷和堿性磷酸酶(AKP)變化。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為65.0%、96.7%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,治療組患者L1～4 BMD、血鈣均較治療前顯著升高,AKP、VAS評(píng)分顯著降低,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05、0.01);且治療組的改善程度優(yōu)于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 唑來膦酸聯(lián)合碳酸鈣D3治療骨質(zhì)疏松癥具有較好的臨床療效,可以緩解患者疼痛,改善和維持BMD水平,且安全性高,值得臨床推廣應(yīng)用。

Objective To evaluate the clinical efficacy of zoledronic acid combined with calcium carbonate D3 in treatment of osteoporosis. Methods The patients with osteoporosis (120 cases) of Ninth People's Hospital of Zhengzhou City from January 2010 to September 2013 were randomly divided into control and treatment groups, and each group had 60 cases. The patients in the control group were po administered with Calcium Carbonate D3 Tablets, 1 tablet/time, twice daily. The patients in the control group were iv administered with Zoledronic Acid Injection (5 mg diluted with 100 mL physiological saline) more than 15 min, 1 time/year. The patients in two groups were treated for one year. After the treatment, the efficacy was evaluated, and the changes of BMD, VAS score, blood calcium, phosphorus and AKP were compared in two groups. Results The efficacies in the control and treatment groups were 65.0% and 96.7%, respectively, and there were differences between two groups (P< 0.05). After treatment, BMD of L1-4 and blood calcium in treatment group were significantly elevated, while the AKP and VAS score was significantly reduced, and the differences were statistically significant in the same group (P< 0.05, 0.01). Degree of the improvement in the treatment group was better than that in the control group, with significant difference between two groups (P< 0.05). Conclusion Zoledronic acid combined with calcium carbonate D3 has the good clinical effect in treatment of osteoporosis, and can relieve patients' pain, while can improve and maintain the BMD level with high safety, which is worth clinical promotion.