地舒单抗对绝经后骨质疏松性股骨颈骨折全髋关节置换术后股骨近端假体周围骨密度的影响
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作者Author单位AddressE-Mail
宁伟宏 NING Wei-hong 湖州市长兴县中医院骨科, 浙江 湖州 313100 Department of Orthopaedics, Traditional Chinese Medical Hospital of Changxing, Huzhou 313100, Zhejiang, China nwh1997@126.com 
徐国柱 XU Guo-zhu 湖州市长兴县中医院骨科, 浙江 湖州 313100 Department of Orthopaedics, Traditional Chinese Medical Hospital of Changxing, Huzhou 313100, Zhejiang, China  
王建伟 WANG Jian-wei 湖州市长兴县中医院骨科, 浙江 湖州 313100 Department of Orthopaedics, Traditional Chinese Medical Hospital of Changxing, Huzhou 313100, Zhejiang, China  
期刊信息:《中国骨伤》2023年,第36卷,第11期,第1041-1045页
DOI:10.12200/j.issn.1003-0034.2023.11.007
基金项目:
中文摘要:

目的:研究地舒单抗对绝经后骨质疏松性股骨颈骨折患者全髋关节置换术后(total hip arthroplasty,THA)股骨近端假体周围骨密度的影响。

方法:选取2020年10月至2021年10月绝经后女性骨质疏松性股骨颈骨折行THA术后54例,治疗组25例接受地舒单抗治疗,年龄(74.3±6.2)岁;对照组29例未接受地舒单抗治疗,年龄(75.2±4.8)岁。术后1周及3、6及12个月各个时间点,通过双能X线骨密度仪(DEXA型)测定股骨近端假体周围骨密度,并在不同时间点测量骨转换各项指标。

结果:术后3、6及12个月对照组的抗酒石酸酸性磷酸酶(tartrate resistant acid phosphatase,TRACP-5b)高于治疗组(P<0.05);对照组术后12个月骨特异性碱性磷酸酶(bone-specific alkaline phosphatase,BALP)高于治疗组(P<0.05)。两组患者Gruen 1、7区的骨密度在术后3、6及12个月较术后1周(基线)均下降(P<0.05);对照组Gruen 7区术后各时间点比较,差异有统计学意义(P<0.05);治疗组各时间点比较,差异无统计学意义(P>0.05)。两组术后3个月Gruen 1、7区比较,差异无统计学意义(P>0.05);术后6个月Gruen 1、7区和术后12个月Gruen 1、7区,治疗组骨密度均明显高于对照组(P<0.05)。两组术后3个月Gruen 1、7区骨密度下降百分比比较,差异无统计学意义(P>0.05)。对照组术后6个月Gruen 1、7区,术后12个月Gruen 1、7区骨密度下降百分比明显高于治疗组(P<0.05)。提示在使用地舒单抗6个月后,即可降低骨密度丢失幅度,并且该效应可达至术后12个月。

结论:绝经后骨质疏松性股骨颈骨折患者在THA术后,使用地舒单抗可减少股骨近端假体周围骨密度丢失,有效抑制骨吸收。
【关键词】地舒单抗  绝经后骨质疏松  全髋关节置换术
 
Effects of denosumab on bone mineral density around proximal femoral prosthesis after total hip replacement in postmenopausal osteoporotic patients
ABSTRACT  

Objective To evaluate the effect of denosumab on bone mineral density around proximal femoral prosthesis after total hip arthroplasty(THA) in the postmenopausal osteoporotic patients.

Methods Fifty-four consecutive patients underwent unilateral primary THA were included in this retrospective study. Twenty-five patients received denosumab for osteoporosis as the treatment group,and the twenty-nine without denosumab were the control group. At 1 week,3month,6 months,and 12 months after THA,bone turnover markers and proximal femoral periprosthetic bone mineral density (BMD) were measured.

Results At 3,6 and 12 months after operation,the level of TRACP-5b in the control group was significantly higher than that in the treatment group (P<0.05);the level of bone-specific alkaline phosphatase (BALP) between two groups showed significant difference in 12 months after operation (control group was higher than treatment group,P<0.05). The BMD of Gruen 1 and Gruen 7 decreased at 3,6 and 12 months after operation compared with 1 week after operation. Comparing the treatment group and the control group,the differences of the the decrease of BMD in Gruen 1 and Gruen 7 were no significant at 3 months after surgery. In Gruen 1,Gruen 7 at 6 months after operation and Gruen 1,Gruen 7 at 12 months after operation,the decrease of BMD in the control group was significantly higher than that in the treatment group(P<0.05). It is suggested that desudumab could inhibit the loss of BMD after 6 months,and continuously show a protective effect on bone mass at 12 months after operation.

Conclusion After THA in postmenopausal patients with osteoporotic femoral neck fracture,Desuzumab can reduce the loss of BMD around the proximal femoral prosthesis and effectively inhibit bone resorption.
KEY WORDS  Denosumab  Postmenopausal osteoporosis  Total hip arthroplasty(THA)
 
引用本文,请按以下格式著录参考文献:
中文格式:宁伟宏,徐国柱,王建伟.地舒单抗对绝经后骨质疏松性股骨颈骨折全髋关节置换术后股骨近端假体周围骨密度的影响[J].中国骨伤,2023,36(11):1041~1045
英文格式:NING Wei-hong,XU Guo-zhu,WANG Jian-wei.Effects of denosumab on bone mineral density around proximal femoral prosthesis after total hip replacement in postmenopausal osteoporotic patients[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(11):1041~1045
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