目的 观察阿仑膦酸钠联合鲑降钙素治疗骨质疏松性股骨转子间骨折的临床疗效。方法 选取衡水市第五人民医院骨科2011年2月-2013年10月收治的老年骨质疏松性股骨转子间骨折患者106例,随机分为对照组与治疗组,每组53例。两组患者均给予内固定术。对照组术后第1天开始皮下注射鲑降钙素注射液50 U/次,1次/d,2～4周后隔日50 U/次。治疗组术后1周内开始口服阿仑膦酸钠片,每日早餐前至少30 min空腹用200 mL温开水送服1片/次,1次/d。其他治疗同对照组。两组均连续治疗36周。比较两组患者治疗前后视觉模拟评级法(VAS)、Harris评分、髋部骨密度、愈合时间以及生化指标的变化。结果 治疗后,两组患者VAS评分和Harris评分均较治疗前有所改善,髋部骨密度均显著提高,同组治疗前后比较差异有统计学意义(P<0.05)。且治疗后治疗组髋部骨密度高于对照组,两组比较差异有统计学意义(P<0.05)。两组骨钙素、血鳞、尿钙/尿肌酐均较治疗前显著升高,血钙、羟脯氨酸/尿肌酐较治疗前降低,同组治疗前后差异有统计学意义(P<0.05)。且治疗组骨钙素、血鳞、碱性磷酸酶、羟脯氨酸/尿肌酐的改善程度优于对照组,两组比较差异有统计学意义(P<0.05)。结论 阿仑膦酸钠联合鲑降钙素治疗骨质疏松性股骨转子间骨折虽对骨折的愈合以及功能恢复无明显影响,但对骨密度的提升有明显增强作用,可促进血钙的吸收。

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.