1 惠东县人民医院骨科，广东 惠州 516300
目的：探讨特立帕肽在老年性股骨粗隆间骨折保守治疗中对骨密度的影响及临床疗效。方法：回顾性分析2017年3月至2018年3月惠东县人民医院接诊的100例老年性股骨粗隆间骨折临床资料，通过治疗方式不同分为观察组55例和对照组45例，两组患者均给予基础常规保守治疗，观察组在基础保守治疗的基础上给予特立帕肽注射液治疗，对照组在基础保守治疗的基础上给予生理盐水皮下注射，比较两组下床活动时间、骨折愈合时间、不同时间点骨标志物、骨密度的变化及Harris评分优良率。结果：观察组下床活动时间、骨折愈合时间明显短于对照组(P<0.05)；治疗后1，3，6个月时，两组N-末端I型前胶原肽(type I procollagen peptide，PINP)、骨钙素(osteocalcin，OC)、骨特异性碱性磷酸酶(bone-specific alkaline phosphatase，BSAP)较治疗前均明显增加，C-末端肽I型胶原蛋白(C-terminal peptide type I collagen，CTX)明显降低(P<0.05)，两组PINP，OC，BSAP，CTX在组间、不同时间点、组间·不同时间点之间的交互作用比较差异有统计学意义(P<0.05)；治疗后1，3，6个月两组骨密度较治疗前均显著增加(P<0.05)；两组骨密度在组间、不同时间点、组间不同时间点之间的交互作用比较差异有统计学意义(P<0.05)；治疗后6个月时观察组Harries评分优良率明显高于对照组，差异具有统计学意义(P<0.05)。结论：特立帕肽在老年性股骨粗隆间骨折保守治疗中效果显著，可有效改善血清骨标志物及骨密度的表达，促进关节功能恢复，临床应用价值高。
Effect of teriparatide on bone mineral density and its clinical efficacy in conservative treatment of senile intertrochanteric fracture
CorrespondingAuthor: LIU Kexing
This work was supported by Huizhou Science and Technology Project, Guangdong Province
Objective: To investigate the effect of teriparatide on bone mineral density and its clinical efficacy in conservative treatment of senile intertrochanteric fractures. Methods: One hundred cases of senile femoral intertrochanteric fractures from March 2017 to March 1818 in Huidong People’s Hospital were retrospectively analyzed. The treatment was divided into observation group 55 cases and control group 45 cases. The two groups of patients were given basic conservative treatment. The observation group was treated with teriparatide on the basis of basic conservative treatment, and the control group was given subcutaneous injection of saline on the basis of basic conservative treatment. Comparing the time of getting out of bed, the time of fracture healing, the changes of bone markers, bone mineral density and the excellent rate of Harris score at different time points. Results: The time of getting out of bed and the time of fracture healing in the observation group were significantly shorter than those in the control group (P<0.05). At 1, 3, and 6 months after treatment, the N-terminal type I procollagen peptide (PINP), osteocalcin (OC) and bone-specific alkaline phosphatase (BSAP) were significantly increased compared with those before treatment, and C-terminal peptide type I collagen (CTX) was significantly decreased (P<0.05). Two groups of PINP, OC, BSAP There was a statistically significant difference in the interaction between CTX between groups, at different time points, between groups, and at different time points (P<0.05). At 1 month, 3 months, and 6 months after treatment, the two groups Bone mineral density was significantly increased compared with that before treatment (P<0.05). There was significant difference in the interaction between bone mineral density between groups, at different time points, between groups and at different time points (P<0.05). At the last 6 months, the excellent rate of Harries score in the observation group was significantly higher than that in the control group (P<0.05). Conclusion: Teriparatide is effective in the conservative treatment of senile intertrochanteric fractures, which can effectively improve the expression of serum bone markers and bone mineral density, promote joint function recovery, and has high clinical value.
elderly; intertrochanteric fracture; teriparatide; bone density