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目的肺癌骨转移伴骨质疏松患者病情复杂,生活质量较差,涉及多学科综合诊疗。探讨唑来磷酸联合密钙息治疗肺癌骨转移伴骨质疏松的疗效和不良反应。方法选取2009年1月—2013年1月200例肺癌骨转移伴骨质疏松患者按随机数字表均分为2组,每组各100例。对照组予常规放化疗抗癌治疗,研究组在常规治疗的基础上使用4 mg唑来磷酸注射液1次/月,联合50~100 IU密钙息治疗。治疗3个月后,观察2组骨密度、骨代谢指标、疼痛、体力状况、骨转移病灶及不良反应等。结果研究组骨密度(t=-0.468,P=0.00)、骨代谢指标(NTx:t=3.127,P=0.03;BSP:t=4.961,P=0.02;Ca:t=-1.316,P=0.00;BGP:t=3.273,P=0.03;CTX:t=-0.351,P=0.01)、疼痛(u=3.391,P=0.02)、体力状况(u=3.621,P=0.04)、骨转移病灶(u=2.832,P=0.00)等情况改善均优于对照组,差异有统计学意义(P<0.05)。骨骼相关事件(χ2=4.275,P=0.01)及不良反应发生率(χ2=3.782,P=0.02)低于对照组,差异有统计学意义(P<0.05)。结论唑来磷酸联合密钙息治疗肺癌骨转移伴骨质疏松有较好的临床疗效,能有效缓解疼痛,改善骨质疏松临床症状,提高日常生活质量,降低骨转移病灶发生率,骨骼相关事件及不良反应发生率较低。
Objectives Patients with lung cancer with bone metastases and osteoporosis have complicated conditions and poor quality of life, involving multidisciplinary comprehensive treatment. To investigate the curative effect and adverse reaction of zoledronic acid combined with Mi-C in the treatment of bone metastasis of lung cancer with osteoporosis. Methods From January 2009 to January 2013, 200 patients with bone metastases of lung cancer and osteoporosis were randomly divided into two groups (100 in each group). The control group received conventional radiotherapy and chemotherapy anticancer treatment, the study group on the basis of conventional treatment using 4 mg zoledronic acid injection once / month, combined with 50 ~ 100 IU close calcium treatment. After 3 months of treatment, two groups of bone mineral density, bone metabolism index, pain, physical condition, bone metastasis and adverse reactions were observed. Results The bone mineral density (t = -0.468, P = 0.00), bone metabolism index (NTx: t = 3.127, P = 0.03; BSP: t = 4.961, P = 0.02; (U = 3.391, P = 0.02), physical status (u = 3.621, P = 0.04), bone metastases u = 2.832, P = 0.00). The difference was statistically significant (P <0.05). Bone-related events (χ2 = 4.275, P = 0.01) and adverse reactions (χ2 = 3.782, P = 0.02) were lower than those in the control group (P <0.05). Conclusion Zoledronic acid combined with calcein is effective in treating bone metastases of lung cancer with osteoporosis. It can effectively relieve pain, improve the clinical symptoms, improve the quality of daily life, reduce the incidence of bone metastases, and bone-related events And the incidence of adverse reactions is low.