唑来膦酸联合碳酸钙D3对老年骨质疏松患者骨代谢及预后的影响OACSTPCD

OBJECTIVE:To probe into the effects of zoledronic acid combined with calcium carbonate D3 on bone metabolism and prognosis in senile patients with osteoporosis.METHODS:A prospective randomized controlled trial design was used to extract 104 senile patients with osteoporosis admitted into this hospital from Jan.2021 to Jun.2022,which were divided into control group and research group via stratified randomization,with 52 cases in each group.Patients in both groups had adjusted lifestyle,supplemented with calcium,and exercised appropriately;the control group was given zoledronic acid,and the research group was given zoledronic acid combined with calcium carbonate D3.The bone mineral density(BMD),bone metabolism,cytokines,clinical efficacy and incidences of adverse drug reactions were compared between two groups,and the short-term prognosis of both groups was evaluated by following up the patients once a month for three times after treatment.RESULTS:After treatment,compared with the control group,the BMD in lumbar vertebrae L1-4,hip,Wards'triangle and femoral neck of the research group were increased,with statistically significant differences(P<0.05).After treatment,compared with the control group,the levels of type Ⅰ collagen amino acid extension peptide,osteocalcin,type Ⅰ collagen carboxy-terminal cross-linked peptide and tartrate-resistant acid phosphatase-5b decreased,and the bone alkaline phosphatase level increased in the research group;compared with the control group,the expression quantity of osteoprotectin(OPG)increased,the expression quantities of receptor activator of nuclear factor κB ligand(RANKL)and receptor activator of nuclear factor κB(RANK)decreased in the research group;compared with the control group,the levels of tumour necrosis factor α,interleukin 6 and γ-interferon decreased in the research group,all of the above differences were statistically significant(P<0.05).The total effective rate of the research group was 94.23%(49/52),higher than 80.77%(42/52)of the control group,with statistically significant difference(P<0.05).The incidences of adverse drug reactions in research group and control group were respectively 9.62%(5/52)and 7.69%(4/52),the difference was not statistically significant(P>0.05).The short-term good prognosis rate of the research group was 90.38%(47/52),higher than 75.00%(39/52)of the control group,the difference was statistically significant(P<0.05).CONCLUSIONS:The combination of zoledronic acid and calcium carbonate D3 may improve cytokine expression,correct bone metabolism abnormalities,and improve prognosis by regulating the OPG/RANKL/RANK signaling pathway.