Treatment Effects Of Zoledronic Acid For The Different Age Spans Of Femail Patients With Primary-osteoporosis

Objective To explore and analyze treatment effects of zoledronic acid for different age spans of femail patients with Primary-osteoporosis.Method This study is a retrospective clinical study,161 postmenopausal patients with primary-osteoporosis,who were treated in ward of the First Affiliated Hospital of Guangxi Medical University from January 2012 to December 2018 ware theated with zoledronic acid.all of them received Caltrate D and Calcitriol Capsules as routine treatmen,and received an intravenous injection of 5mg Aelasta once a year.depand on the age of the first time and the number of times treated with zoledronic acid,the patients were randomly divided into 4 groups:the age of the first time treated with zoledronic acid of group A is less than 70 years old;group B is more-than-or-equal-to 70 years old;the state of0 month is base value(before treatment);12 month and 24 monthis the state of twelfth mouth after the first and the second time receive zoledronic acid treatment respectively.groupA1(n=67)and B1(n=94)including all subject of group A and B respectively;observing the therapeutic effect of zoledronic acid for the first time in all subject,collecting the stste of 0 and 12 mouth;groupA2(n=31)and B2(n=51)collect the subjects who received 2 injections of zoledronic acid of each group respectively,inclusion the stste of 0,12 and 24 month.bone mineral density(BMD),incidence of new fractures and biochemical index including calcium,phosphorus,25(OH)D,ALP,OC and PTH were measured before and after treatment within the groups.and the change of BMD and biochemical indexware compared among groups.Results(1)changeof BMD:After 12 months of treatment,the increase in lumbar spine(L1-4),Ward’s triangle and left femoral neck BMD were significantly greater in group A1(P<0.05);the increase in L1-4,left femoral and left femoral neck BMD were significantly greater in group B1(P<0.05);In group A2 and B2,after 12 months and 24 mouths of treatment,the increase in L1-4 and left femoral neck BMD were significantly greater(P<0.05);in group A2,compere with 12 month,the increase in L1-4 and left femoral neck BMD of 24 mouth were significantly greater(P<0.05);In group B2,compere with 12 month,the increase in L1-4 and left femoral neck BMD of 24 mouth were no significant difference(P>0.05);group A1 VS group B1 and group A2 VS group B2,after 12 months treatment,the change of L1-4,Ward’s triangle,left femoral and left femoral neck were no significant difference(P>0.05);group A2 VS group B2,the change of L1-4,Ward’s triangle,left femoral and left femoral neck between 24 mouth and 0 mouth,12 mouth and 24 mouth,were no significant difference(P>0.05).(2)change of biochemical index :After 12 months of treatment,the reduce in OC and ALP were significantly greater in group A1 and B1(P<0.05);in group A2 and B2,after 12 months and 24 mouths of treatment,the reduce in OC and ALP were significantly greater(P<0.05),compare with 12 mouth,the reduce in OC and ALP of 24 mouth were significantly greater(P<0.05).after treated with zoledronic acid,serum creatinine of both groups(A and B)are increased,but theywere within the normal range,and the difference was not statistically significant(P>0.05).(3)incidence of new fractures:after treated with zoledronic acid,the incidence of new fractures of 12 and 24 mouth decreased in both group A and B,compared with patients without a history of fracture,the patient who with a fractures history had a higher incidence of new fractures;the patients who with a lower bone mineral density of L1-4 at the time of enrollment,a higher incidence of new fractures they gain;compared with the patients of group A(age<70),the incidence of new fractures was higher in patients of group B(age≥70).Conclusion(1)the treating effects of zoledronic acid to different age spans of femail patients with Primary-osteoporosis are comparable.(2)to the femail patients with Primary-osteoporosis,treating with zoledronic acid can improve BMD,decrease the level of ALP and OC,and reduce the incidence of new fracture.(3)postmenopausal patients with primary-osteoporosis who treated with zoledronic acid,the incidence of new fractures of them may be related to the history of fracture before treatment,L1-4 bone mineral density and age.