(1. 深圳大学第一附属医院 深圳市第二人民医院，广东 深圳 518035;2. 深圳市糖尿病防治中心，广东 深圳 518035)
(1.The First Affiliated Hospital of Shenzhen University Shenzhen Second People's Hospital, Guangdong Shenzhen 518035; 2. Shenzhen Diabetes Center, Guangdong Shenzhen 518035)
〔摘 要〕 目的：探讨采用唑来膦酸联合骨化三醇治疗骨质疏松症患者对其骨代谢指标、骨密度水平及生活质量的影响。 方法：选取 2017 年 7 月至 2019 年 7 月深圳大学第一附属医院收治的 68 例骨质疏松症患者，按治疗方法不同分为观察组 及对照组各 34 例。对照组予以患者骨化三醇及钙剂进行治疗，观察组在对照组基础上予以患者唑来膦酸注射液进行治疗。 比较两组患者治疗前后的骨代谢及骨密度水平、国际骨质疏松生活质量评估表（QUALEFFO–41）评分以及治疗期间用药安 全性。结果：治疗后，观察组患者骨特异性碱性磷酸酶（BLAP）水平高于对照组，Ⅰ型胶原交联 C 端肽（β–CTX）、骨钙 素 N 端中分子片段（N–MID）及抗酒石酸盐酸性磷酸酶异构体 –5b（TRACP–5b）水平低于对照组，差异具有统计学意义 （P ＜ 0.05）；观察组患者的腰椎、股骨颈、髋部骨密度水平较对照组更高，QUALEFFO–41 评分中疼痛程度、社会功能、 心理状态、身体健康状况自我评价、活动性、日常及家务活动等评分均低于对照组，差异均具有统计学意义（P ＜ 0.05）； 两组患者治疗期间均无严重不良反应发生。结论：对骨质疏松症患者采用唑来膦酸联合骨化三醇进行治疗，可改善患者骨 代谢指标与骨密度水平，提高生活质量，疗效好、安全性佳。
〔Abstract〕 Objective To explore the effect of zoledronic acid combined with calcitriol in the treatment of osteoporosis on bone metabolism indexes, bone mineral density and quality of life. Methods A selection of 68 patients with osteoporosis admitted to the hospital from July 2017 to July 2019 were divided into observation group (34 cases) and control group (34 cases) according to different treatment methods. The control group was treated with calcitriol and calcium, and the observation group was treated with zoledronic acid injection on the basis of the control group. Compare the bone metabolism indexes and bone mineral density levels of the two groups before and after treatment. The safety of medication during treatment was compared between the two groups of patients. The quality of life (QUALEFFO–41) scores before and after treatment were compared between the two groups. The safety of medication during treatment was compared between the two groups of patients. Results After treatment, the level of bone– specific alkaline phosphatase (BLAP) in the observation group was higher than that in the control group. Type I collagen cross–linked C–terminal peptide (β–CTX), osteocalcin N–terminal mid–molecular fragment (N–MID) and anti–tartaric acid The level of hydrochloric phosphatase isoform–5b (TRACP–5b) was lower than that of the control group (P < 0.05). After treatment, the bone mineral density levels of the lumbar spine, femoral neck and hip of the observation group were higher than those of the control group (P < 0.05). In the QUALEFFO–41 score of the observation group, the scores of pain degree, social function, mental state, physical health status, self–evaluation, activity, daily and housework activities were lower than those of the control group (P < 0.05). No serious adverse reactions occurred during the treatment of the two groups. Conclusions The treatment of osteoporosis patients with zoledronic acid combined with calcitriol can improve the bone metabolism index and bone density of the patients, and improve the quality of life, with good curative effect and good safety.