重组人骨保护素对激素性股骨头坏死患者骨密度及髋关节Harris评分的影响

目的:探讨重组人骨保护素对于激素性股骨头坏死患者的骨密度和髋关节Harris评分的影响。方法:选取我院骨科已经确诊的110例激素性股骨头坏死患者,随机分为对照组(给予仙灵骨葆胶囊)和观察组(给予仙灵骨葆胶囊和重组人骨保护素),连续治疗4周,检测并比较两组患者治疗前后的骨密度、髋关节Harris评分、血清抗酒石酸酸性磷酸酶(TRAP)、Ⅱ型胶原羧基端端肽(CTX-Ⅱ)水平以及复发率变化。结果:与对照组相比较,观察组患者腰椎骨和股骨近端的骨密度较高平(P0.05);髋关节Harris评分总有效率(92.73%)显著高于对照组(76.36%)(P0.05)。两组血清TRAP及CTX-Ⅱ水平显著低于治疗前,且试验组血清TRAP及CTX-Ⅱ水平显著低于对照组(P0.05),与对照组相比,观察组复发率较低(P0.05)。结论:重组人骨保护素能够抑制骨吸收,提高骨密度和强度,改善髋关节功能,有望成为激素性股骨头坏死的新型治疗方法。

Study on the Recombinant Human Bone Protective Elementof Bone Mineral Density and Hip Harris Score in Steroid induced Necrosisof the Femoral Head*

Objective:To investigate the recombinant human bone protective element of bone mineral density and hip Harris scorein steroid induced necrosis of the femoral head.Methods:110 steroid induced femoral head necrosis were selected and randomly dividedinto the control group were treated by Xianlinggubao capsule and the experiment group were treated by Xianlinggubao capsule andrecombinant human osteoprotegerin. Bone density, Harris hip score, serum tartrate resistant acid phosphatase (TRAP) and type IIcollagen C-terminal end of the peptide (CTX II) level and recurrence rate were compared after continuous treatment for 4 weeks.Results:Compared with control group, bone mineral density of lumbar vertebra and proximal femur were higher (P<0.05), the Hip Harris scorewere higher (P<0.05).Compared with before treatment, 2 groups of serum telomeric repeat amplification protocol (TRAP) and CTX IIlevels were significantly lower and telomeric repeat amplification protocol (TRAP) and CTX II level in serum in experiment group waeresignificantly lower than that the control group (P < 0.05), and compared with the control group, the recurrence rate of the experimentgroup was lower (P < 0.05).Conclusion:Bone protection can inhibit bone resorption, improve bone density and intensity, improve thefunction of hip joint, and may become a new method for treatment of steroid induced femoral head necrosis.