目的：探讨唑来膦酸辅助治疗骨质疏松性椎体压缩骨折对胰岛素样生长因子(insulin-like growth factor)-1、趋化素(chemerin)表达的影响。方法：2015年8月到2018年10月选择在本院诊治的骨质疏松性椎体压缩骨折患者146例作为研究对象,根据治疗方法的不同分为研究组100例与对照组46例。所有患者都给予经皮椎体成形术治疗,对照组术后给予阿仑膦酸钠辅助治疗,研究组术后给予唑来膦酸辅助治疗,记录血清IGF-1、chemerin表达变化情况。结果：所有患者都顺利完成手术,无严重并发症发生；研究组与对照组时间消耗指标与出血量指标比较无差异(P>0.05)。研究组术后3个月、12个月的胸腰段骨密度T值都显著高于对照组(P<0.05)。研究组术后3个月、12个月的Cobb角低于对照组,Beck指数高于对照组,对比差异都有统计学意义(P<0.05)。研究组术后3个月、12个月的血清IGF-1、chemerin值都显著低于对照组(P<0.05)。结论：唑来膦酸辅助治疗骨质疏松性椎体压缩骨折能抑制IGF-1、chemerin的表达,有利于改善患者椎体的生物力学状况,促进恢复骨密度。

Objective: To investigate the effects of zoledronic acid in the treatment of osteoporotic vertebral compression fractures on the expression of insulin-like growth factor-1 and chemerin. Methods: From August 2015 to October 2018, 146 cases of patients with osteoporotic vertebral compression fractures treated in our hospital were selected as the research subjects andwere divided into study group of 100 patients and the control group of 46 patients accorded to different treatment methods. All patients were treated with percutaneous vertebroplasty. The control group were received adjuvant alendronate after surgery, the study group were received adjuvant zoledronic acid after surgery. The changes of serum IGF-1 and chemerin expression were recorded. Results: All patients were successfully completed the operation without serious complications. There was no difference in time consumption index and blood loss index between the study group and the control group (P>0.05).T-thoracolumbar bone mineral density T values in the study group at 3 and 12 months after surgery were significantly higher than those in the control group (P <0.05). The Cobb angle of the study group at 3 and 12 months after surgery in the study group were lower than that of the control group, and the Beck index were higher than that of the control group, and compared the differences were statistically significant (P <0.05). The serum IGF-1 and chemerin values in the study group at 3 and 12 months after operation were significantly lower than those in the control group (P <0.05). Conclusion: Zoledronic acid in adjuvant treatment for osteoporotic vertebral compression fractures can inhibit the expression of IGF-1 and chemerin, and is beneficial to improve the biomechanical status of the vertebral body and promote the restoration of bone density.

项目编号:2019SA1202