目的 觀察阿侖膦酸鈉聯(lián)合鮭降鈣素治療骨質(zhì)疏松性股骨轉(zhuǎn)子間骨折的臨床療效。方法 選取衡水市第五人民醫(yī)院骨科2011年2月-2013年10月收治的老年骨質(zhì)疏松性股骨轉(zhuǎn)子間骨折患者106例,隨機分為對照組與治療組,每組53例。兩組患者均給予內(nèi)固定術(shù)。對照組術(shù)后第1天開始皮下注射鮭降鈣素注射液50 U/次,1次/d,2～4周后隔日50 U/次。治療組術(shù)后1周內(nèi)開始口服阿侖膦酸鈉片,每日早餐前至少30 min空腹用200 mL溫開水送服1片/次,1次/d。其他治療同對照組。兩組均連續(xù)治療36周。比較兩組患者治療前后視覺模擬評級法(VAS)、Harris評分、髖部骨密度、愈合時間以及生化指標(biāo)的變化。結(jié)果 治療后,兩組患者VAS評分和Harris評分均較治療前有所改善,髖部骨密度均顯著提高,同組治療前后比較差異有統(tǒng)計學(xué)意義(P<0.05)。且治療后治療組髖部骨密度高于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。兩組骨鈣素、血鱗、尿鈣/尿肌酐均較治療前顯著升高,血鈣、羥脯氨酸/尿肌酐較治療前降低,同組治療前后差異有統(tǒng)計學(xué)意義(P<0.05)。且治療組骨鈣素、血鱗、堿性磷酸酶、羥脯氨酸/尿肌酐的改善程度優(yōu)于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 阿侖膦酸鈉聯(lián)合鮭降鈣素治療骨質(zhì)疏松性股骨轉(zhuǎn)子間骨折雖對骨折的愈合以及功能恢復(fù)無明顯影響,但對骨密度的提升有明顯增強作用,可促進血鈣的吸收。

Objective To explore the efficacy of alendronate sodium combined with calcitonin in treatment of osteoporotic femoral intertrochanteric fractures. Methods The patients with elderly osteoporotic femoral intertrochanteric fractures (106 cases) of the Fifth People's Hospital of Hengshui City from February 2011 to October 2013 were randomly divided into control and treatment groups, and each group had 53 cases. The patients of two groups were given fixation. The patients in the control group were sc Salmon Calcitonin Injection on the first day after the operation, 50 U/time, once daily, and 50 U/time every other day after 2-4 weeks. The patients in the control group were po Alendronate Sodium Tablets, at least 30 min before breakfast with 200 mL warm water on an empty stomach, 1 tablet/time, once daily. Other treatment was the same with the control group. The patients in two groups were treated for 36 weeks. The changes of VAS score, Harris score, mineral density of hip bone, healing time, and biochemical indexes were compared between two groups. Results After treatment, VAS score, Harris score, and mineral density of hip bone in two groups were improved, and the difference was statistically significant in the same group (P< 0.05). After treatment, mineral density of hip bone in treatment group was higher than that in the control group, with significant difference between two groups (P< 0.05). Osteocalcin, blood scales and urinary calcium/urinary creatinine in two groups were significantly increased, while the blood calcium and hydroxyproline/urinary creatinine were reduced, and the difference was statistically significant in the same group (P< 0.05). And the improvement levels of osteocalcin, blood scales, alkaline phosphatase, and hydroxyproline/urinary creatinine in the treatment group were better than those in control group, with significant difference between two groups (P< 0.05). Conclusion Alendronate sodium combined with calcitonin has no significant effect on fracture healing and functional recovery, but has obvious enhancement effect on the promotion of bone mineral density, which can promote the absorption of blood calcium.