阿仑膦酸钠联合阿法骨化醇对预防全髋关节置换术后患者骨矿物质流失的疗效

目的：探讨初次行全髋关节置换术后使用阿仑膦酸钠单一用药或阿仑膦酸钠与阿法骨化醇联合用药对患者假体周围骨矿物 质流失的疗效。方法：将60 名患者按照随机数字表法分为阿仑膦酸钠单一药物治疗组（n=18）、阿仑膦酸钠和阿法骨化醇联合治 疗组（n=20）和无药物治疗组（n=22）。术后1、12、24 和48 周，对患者假体周围骨矿物质密度（BMD）和生化标志物进行检测，比较 检测区域测量值的变化。结果：单个测量周期中，单一药物治疗组和联合药物治疗组在股骨矩区域的BMD 均高于无药物治疗组 （P＜0.01）。单一药物治疗组和联合药物治疗组尿Ⅰ型胶原N端肽的血浆浓度与骨碱性磷酸酶浓度显著低于无药物治疗组（P＜ 0.01）。结论：单一药物治疗和联合治疗能显著预防假体周围的骨矿物质流失，尤其对预防股骨矩位置的骨矿物质流失效果显著。

Study on Efficacy of Alendronate SodiumMonotherapy or Alendronate and Alfacalcidol Combined Treatment on the Loss of Bone Mineral Density in Patients after Total Hip Replacement

Objective:To compare the effects of alendronate sodium monotherapy and combination therapy of alendronate and alfacalcidol on bone mineral density around the prosthesis after primary total hip arthroplasty.Methods:The selected 60 patients were randomly divided into the alendronate sodiums monotherapy group (n=18), alendronate and alfacalcidol combined-therapy group (n = 20) and non-medication treatment group (n=22). At 1 week, 12, 24 and 48 weeks after operation, the periprosthetic bone mineral density (BMD) and biochemical markers were measured and compared.Results:In each measurement period, the BMD value of alendronate monotherapy group and alendronate and alfacalcidol combined-therapy group were higher than that of non-medication treatment group in the region of the calcar (P < 0.01). The plasma levels of N-terminal telopeptides of type-1 collagen (NTX) in the monotherapy and combined-therapy groups were found to be significantly lower than those in the non-medication group at each measurement period. (P<0. 01).Conclusion:The monotherapy and combined-therapy regimens significantly prevent periprosthetic BMD loss around femoral implants, most notably in the calcar.