唑来膦酸治疗骨质疏松症24例临床剖析.docVIP

唑来膦酸治疗骨质疏松症24例临床剖析 　　摘 要 目的：观察临床应用唑来膦酸注射液（密固达）治疗骨质疏松症的疗效及不良反应。 方法：24例原发性骨质疏松症患者经唑来膦酸5 mg静脉输注治疗后，通过复诊及回访，判断其疗效、不良反应和依从性。结果：24例患者疼痛症状改善总有效率为87.5%，常见的不良反应有发热、关节痛、全身肌痛等流感样症状及腹胀腹泻、乏力和食欲不佳等，一般不超过3 d，未出现严重不良反应。大部分患者愿意接受连续治疗。结论：唑来膦酸作为一年注射一次的疗法，方便简单，有确切的提高骨密度的疗效和降低新发骨折的风险和改善生存期，安全性和依从性较好。 　　关键词 唑来膦酸 密固达 骨质疏松 疗效 不良反应 　　中图分类号：R977.9； R969.4 文献标识码：B 文章编号：1006-1533（2013）21-0024-03 　　Clinical analysis of zoledronic acid in the treatment of 24 cases of osteoporosis 　　WANG Xia 　　（Department of orthopedics， Nantong No. 3 People’s Hospital， Nantong 226006， China） 　　ABSTRACT Objective： To explore the efficacy and adverse reactions of annual intravenous injection of zoledronic acid for osteoporosis. Methods： A retrospective analysis of 24 cases of patients with osteoporosis was performed after they were treated with zoledronic acid. The clinical effect， adverse reactions and compliance were investigated by follow-ups. Results： Most patients （87.5?） had experienced clinical improvements. Common adverse reactions including fever， joint pain， myalgia and influenza-like symptoms， as well as diarrhea， fatigue， poor appetite and atrial fibrillation were observed as reported in literatures and no severe adverse reaction occurred， which only lasted for less than three days. Most patients agreed to continue the annual zoledronic acid treatment. Conclusion： This therapy is simple， convenient with verified efficacy of the improvement of bone mineral density and life expectancy， the reduction of the risk of new fractures， and good safety and compliance. However， close attention should be paid to the long-term efficacy and adverse reactions since the time for domestic application of this drug is short. 　　KEY WORDS zoledronic acid； osteoporosis； efficacy； adverse reaction 　　骨质疏松症是以骨量减少、骨微结构损坏为特征、致使骨脆性增加、容易发生骨折的一种全身性代谢性骨病。主要罹患于绝经后妇女和老年男性，具有高发病率、高死亡率、高致残率和高医疗费用等特征，已受到全球医学界的高度重视 ，WHO将其列为三大老年病之一。我国已经有骨质疏松患者约7 800万人，而骨量减少患者近2亿人，因此，防治任务尤其严峻。二膦酸盐类药物在降低椎体或非椎体骨折的风险中具有显著疗效，口服阿仑膦酸钠疗效确定[1-3]，是临床最常用的抗骨