2020 年第 3 期 第 15 卷

经皮微创椎弓根钉内固定术联合阿仑膦酸钠治疗对老年骨质疏松脊椎骨折患者骨形态发生蛋白和胰岛素样生长因子水平的影响

Effect of percutaneous minimally invasive pedicle screw fixation combined with alendronate sodium on bone morphogenetic protein and insulin-like growth factor in senile osteoporosis patients with spinal fracture

作者：韦勇力陆建猛赵霁俞武良王强王兴武方明

英文作者：

单位：宁波大学医学院附属医院脊柱二科315020

英文单位：

关键词：脊椎骨折；骨质疏松；经皮微创椎弓根钉内固定术；阿仑膦酸钠

英文关键词：

• 摘要：

• 【摘要】目的    分析经皮微创椎弓根钉内固定术联合阿仑膦酸钠治疗老年骨质疏松脊椎骨折的临床效果及对骨形态发生蛋白（BMP）和胰岛素样生长因子（IGF）水平的影响。方法    选取2016年12月至2018年12月宁波大学医学院附属医院诊治的老年骨质疏松脊椎骨折患者116例，按照随机数字表法分为对照组（58例）和观察组（58例）。对照组接受经皮微创椎弓根钉内固定术治疗，观察组接受经皮微创椎弓根钉内固定术联合阿仑膦酸钠治疗。比较2组治疗前后Oswestry功能障碍指数问卷表（ODI）评分、UBA疼痛行为量表（UBA-PBS）评分、骨密度、伤椎高度比、Cobb角、骨形态发生蛋白（BMP）和胰岛素样生长因子（IGF）水平。结果    治疗后，观察组ODI评分及UBA-PBS评分均明显低于对照组［（35±5）分比（45±8）分、（49±9）分比（61±6）分］，骨密度和伤椎高度比明显大于对照组，Cobb角明显小于对照组［（0.96±0.19）g/cm2比（0.84±0.09）g/cm2、（90±8）%比（81±9）%、（11.8±2.1）°比（17.3±3.1）°］，且BMP-2、BMP-7和IGF水平均明显高于对照组（均P＜0.05）。结论    经皮微创椎弓根钉内固定术联合阿仑膦酸钠能有效改善老年骨质疏松脊椎骨折患者的临床指标，可能与其升高血清BMP和IGF水平有关。

  
  

• 【Abstract】Objective    To analyze the clinical efficacy of percutaneous minimally invasive pedicle screw fixation combined with alendronate sodium in treatment of senile osteoporosis patients with spinal fracture and the effect on bone morphogenetic protein（BMP） and insulin-like growth factor（IGF）. Methods    A total of 116 senile patients with osteoporosis and spinal fracture who visited the Affiliated Hospital of Medical College of Ningbo University from December 2016 to December 2018 were randomly divided into control group and observation group, with 58 cases in each group. Percutaneous minimally invasive pedicle screw fixation was successfully performed in all patients and the control group was treated with alendronate. Oswestry Disability Index(ODI), UBA Pain Behavior Scale(UBA-PBS) score, bone mineral density, vertebral height ratio, Cobb angle, levels of BMP and IGF were analyzed. Results    After treatment, ODI and UBA-PBS scores in the observation group were significantly lower than those in the control group［（35±5） vs （45±8）, （49±9） vs （61±6）］; bone mineral density and vertebral height ratio in the observation group were significantly greater while Cobb angle was smaller than those in the control group［（0.96±0.19）g/cm2 vs （0.84±0.09）g/cm2, （90±8）% vs （81±9）%, （11.8±2.1）° vs （17.3±3.1）°］; levels of BMP-2, BMP-7 and IGF in the observation group were significantly higher than those in the control group（all P＜0.05）. Conclusion    Percutaneous minimally invasive pedicle screw fixation combined with alendronate sodium is effective in treating senile osteoporosis patients with spinal fracture; the physiological mechanism may be related with the increase of serum BMP and IGF levels.