Changes in bone metabolism indicators and bone density in patients with failed secondary prevention of osteoporotic vertebral compression fractures
石磊 1刘驰 1尹自龙 1闵楠 1许亚男 1薛庆云1
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作者信息
1. 北京医院骨科国家老年医学中心中国医学科学院老年医学研究院,北京 100730
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摘要
目的 了解骨质疏松性椎体压缩骨折二级预防失败患者骨代谢指标及骨密度的特点.方法 选择2015年1月至2020年1月在我院骨科因骨质疏松性椎体压缩骨折行2次或2次以上手术治疗的患者为观察组研究对象,共65例,同时选择同时期行手术治疗的非多次脊柱压缩骨折患者219例作为配对资料对照组,回顾性分析这284例患者临床资料,记录其术前骨代谢标志物水平及骨密度(bone mineral density,BMD)结果并进行两组患者间比较.结果 观察组患者骨代谢标志物中人血清和血浆中的总I型前胶原氨基端肽(tP1NP)、N-MID骨钙素(OCN)以及血清25-羟维生素D(25-hydroxy vitamin D,25OHD)水平与对照组相比差异无统计学意义(P＞0.05),骨代谢标志物Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平明显高于对照组(P＜0.05).两组患者髋部BMD值、股骨颈BMD值差异无统计学意义(P＞0.05),观察组腰椎BMD值明显低于对照组(P＜0.05).结论 骨质疏松性椎体压缩骨折二级预防失败患者具有更为活跃的骨吸收状态及更低的腰椎骨密度.
Abstract
Objective To investigate the characteristics of bone metabolism markers and bone mineral density in patients with osteoporotic vertebral compression fracture who failed secondary prevention.Methods A total of 65 patients with two or more times osteoporotic vertebral compression fractures who underwent PVP or PKP operations in the Department of Orthopedics of our hospital from January 2015 to January 2020 were selected as the research objects in the observation group,and 219 patients with only one time fractures who underwent surgery in the same period were selected as the control group.The clinical data of the total 284 patients were retrospectively analyzed.The preoperative bone metabolism markers and bone mineral density(BMD)were recorded and compared between the two groups.Results There was no significant difference of tP1NP,OCN and 25OHD between the observation group and the control group(P＞0.05).The levels of β-CTX were significantly higher than those in the control group(P＜0.05).There was no significant difference in hip BMD and femoral neck BMD between the two groups(P＞0.05).The lumbar BMD value in the observation group was significantly lower than that in the control group(P＜0.05).Conclusion Patients with failed secondary prevention of osteoporotic vertebral compression fractures have more active bone resorption state and lower lumbar bone mineral density.
关键词
骨质疏松/压缩骨折/二级预防/骨代谢指标/骨密度
Key words
osteoporosis/compression fracture/secondary prevention/bone metabolism markers/bone mineral density
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