唑来膦酸的作用与效果和副作用？

Osteoporosis is a common clinical disease in orthopedics and a frequently-occurring disease. Driven by the trend of population aging, middle-aged and elderly people are the main disease. In recent years, under the combined action of various internal and external factors, the clinical incidence of this disease has been increasing year by year. When osteoporosis occurs, it is easy to be complicated by distal radius fractures. The course of the disease is long, and the treatment measures are complex and difficult, which seriously affects the patient's health and quality of life. The first-choice anti-osteoporosis drugs recommended in the "Guidelines for Diagnosis and Treatment of Primary Osteoporosis (2017)" are mainly bone resorption inhibitors, including alendronate, denosumab, etc. Zoledronic acid is one of the commonly used anti-osteoporosis drugs. It is widely used in clinical practice and has definite efficacy. So, what are the functions, effects and side effects of zoledronic acid?

The role of zoledronic acid

Compared with other bisphosphonates, the unique diazoimidazole heterocyclic structure of zoledronate enables it to have a higher binding force to hydroxyapatite on the bone surface and a stronger inhibitory effect on KHH synthase. The inhibitory effect of zoledronate on bone metastasis and bone resorption is 100 to 850 times that of previous bisphosphonates. Experiments show that zoledronic acid has the strongest pharmacological activity at present.

The effect of zoledronic acid

Sixty-four diabetic osteoporosis patients admitted to the 989th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force were selected as the research subjects and divided into a research group and a control group according to the random number table method, with 32 cases in each group [1]. The control group was treated with conventional hypoglycemic therapy combined with calcium carbonate D3, and the research group was treated with zoledronic acid injection on the basis of the control group. The efficacy, bone density (lumbar vertebrae, femoral neck, Wards triangle), bone metabolism [osteocalcin (BGP), bone alkaline phosphatase (BALP), blood calcium (Ca), β-collagen fragment (β-CTX)] and incidence of adverse reactions were compared between the two groups.

Results: The total effective rate of the study group [93.75% (30/32)] was higher than that of the control group [75.00% (24/32) (P<0.05). After 3 years of treatment, the levels of lumbar vertebrae, femoral neck, and Wards triangle in the study group were higher than those of the control group (P<0.05). After 3 years of treatment, the calcium levels of the two groups were compared, and the difference was not statistically significant (P>0.05) , the levels of BCP and BALP.β-CTX in the study group were lower than those in the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion: The combined treatment of zoledronic acid injection and calcium carbonate D3 can improve the efficacy, increase bone density, regulate bone metabolism, and is safer in patients with diabetic osteoporosis.

Zoledronic acid side effects

In this experiment, it was found that the main adverse reactions were fever, and other adverse reactions mainly included: systemic reactions: fatigue, chest pain, leg edema, and conjunctivitis.

References

[1] Wang Chunhua, Qin Pengtao, Liu Dongfeng, Wei Gao, Chang Liujun, Zhang Hongyan, Ren Qiao. Effect of zoledronic acid injection combined with calcium carbonate D3 in the treatment of diabetic osteoporosis [J]. Clinical Medicine, 2022, 42(10): 104-106. DOI: 10.19528/j.issn.1003-3548.2022.10.038.

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