2020 年第 2 期 第 15 卷

老年骨质疏松患者唑来膦酸急性期反应与性别和双膦酸盐类药物使用史的关系

Relation among acute phase reaction of zoledronic acid, sexuality and previous use of bisphosphonates in elderly osteoporotic patients

作者：沈佶吴惠英边平达陈锦平

英文作者：

单位：浙江省人民医院杭州医学院附属人民医院望江山院区老年医学科310024

英文单位：

关键词：骨质疏松；唑来膦酸；急性期反应；发热

英文关键词：

• 摘要：

• 【摘要】目的    调查分析老年骨质疏松患者唑来膦酸急性期反应（APR）与性别和双膦酸盐类（BPs）药物使用史的关系。方法    选择2016年1月至2018年12月来浙江省人民医院望江山院区老年医学科住院治疗的115例老年骨质疏松患者。在静脉滴注唑来膦酸（5 mg）后，记录患者在72 h内发热、肌痛、胃肠道症状、流感样症状、神经系统症状等APR的发生情况，并分析APR与性别和BPs药物使用史的关系。结果    不同性别老年骨质疏松患者间常见APR发生率差异均无统计学意义（均P＞0.05）。而有BPs使用史的老年骨质疏松患者发热、肌痛、胃肠道症状、流感样症状、神经系统症状等APR发生率明显低于无BPs使用史的患者［24.4%（11/45）比55.7%（39/70）、22.2%（10/45）比41.4%（29/70）、15.6%（7/45）比34.3%（24/70）、13.3%（6/45）比31.4%（22/70）、11.1%（5/45）比32.9%（23/70）、13.3%（6/45）比34.3%（24/70）］，差异均有统计学意义（均P＜0.05）。发热患者伴随其他APR（2.04±1.68）个，明显高于不发热的患者的（0.75±0.10）个，差异有统计学意义（P＜0.01）。结论    老年骨质疏松患者在接受唑来膦酸治疗后容易出现发热等APR，而有BPs使用史的患者APR较少。

• 【Abstract】Objective    To investigate the relation among acute phase reaction(APR) of zoledronic acid, sexuality and previous use of bisphosphonates in elderly osteoporotic patients. Methods    From January 2016 to December 2018, 115 elderly patients with osteoporosis were hospitalized in Wangjiangshan Branch, Zhejiang Provincial People′s Hospital. All patients had intravenous infusion of zoledronic acid(5 mg). Occurrence of APR such as fever, myalgia, gastrointestinal symptoms, influenza-like symptoms and neurological symptoms were observed. Relations among APR, sexuality and previous use of bisphosphonates were analyzed. Results    There was no significant difference in zoledronic acid-induced APR between males and females(P＞0.05). Incidences of fever, myalgia, gastrointestinal symptoms, influenza-like symptoms and neurological symptoms in patients who had previous use of bisphosphonates were significantly lower than those in patients without bisphosphonates use history［24.4%（11/45） vs 55.7%（39/70）, 22.2%（10/45） vs 41.4%（29/70）, 15.6%（7/45） vs 34.3%（24/70）, 13.3%（6/45） vs 31.4%（22/70）, 11.1%（5/45） vs 32.9%（23/70）, 13.3%（6/45） vs 34.3%（24/70）］(all P＜0.05). Numbers of APR accompanied symptoms in fever patients were significantly more than those in non-fever patients［（2.04±1.68）vs（0.75±0.10）］(P＜0.01). Conclusions    There is a high incidence of APR in elderly osteoporotic patients treated with zoledronic acid. Patients with previous use history of bisphosphonates may have less adverse reaction.