北京大学学报(医学版) ›› 2016, Vol. 48 ›› Issue (4): 680-682. doi: 10.3969/j.issn.1671-167X.2016.04.022

• 论著 • 上一篇    下一篇

口服双膦酸盐用药史对静脉注射唑来膦酸治疗骨质疏松发热不良反应的影响

王翯1,胡肇衡2△,陈玲2,潘宇3   

  1. (1. 河北省保定市第一中心医院内分泌一科, 河北保定071000; 2. 北京大学人民医院内分泌科, 北京100044; 3. 北京昌平区医院内分泌科, 北京 102200)
  • 出版日期:2016-08-18 发布日期:2016-08-18
  • 通讯作者: 胡肇衡 E-mail: huzhaoheng@sina.com

Influence of history of oral bisphosphonates on the incidence rate of fever after intravenous injection of zoledronic acid in patients with osteoporosis

WANG He1, HU Zhao-heng2△, CHEN Ling2, PAN Yu3   

  1. (1. the First Department of Endocrinology and Metabolism, the First Central Hospital of Baoding, Baoding 071000, Hebei, China; 2. Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing 100044, China; 3. Department of Endocrinology and Metabolism, Changping Hospital, Beijing 102200, China)
  • Online:2016-08-18 Published:2016-08-18
  • Contact: HU Zhao-heng E-mail: huzhaoheng@sina.com

摘要:

目的:唑来膦酸作为一种静脉的双磷酸盐类药物已被批准用于治疗骨质疏松症,尤其是对于口服双磷酸盐不耐受或依从性差的患者,但发热等不良反应影响了该药的使用,探讨有口服双膦酸盐史对骨质疏松症患者在首次静脉滴注唑来膦酸(密固达)5 mg后发热率的变化及其影响因素。方法:对在就诊的骨质疏松患者进行双能X线骨密度检查,根据世界卫生组织对骨质疏松的诊断标准,T值≤-2.5被定义为骨质疏松。对其中113例首次静脉滴注唑来膦酸治疗的骨质疏松症患者进行分析,其中有口服阿仑膦酸钠史者35例,记为A组,无口服阿仑膦酸钠史者78例,记为B组。比较治疗前口服双膦酸盐治疗时间与治疗后发热发生率的关系及静脉滴注唑来膦酸后发热的影响因素。结果:35例有口服阿仑膦酸钠史者中,无高热,2例有中低度发热反应(5.71%)。78例无双膦酸盐用药史者中,33人出现发热(42.3%),其中低热15人、中度热14人、高热4人,卡方检验两组差异有统计学意义(P=0.002),另外,对在门诊与病房接受静脉滴注唑来膦酸患者发热情况进行分析,用药地点对发热发生率无影响。二元Logistic回归分析显示口服双磷酸盐用药史是发热的保护性因素,既往口服双膦酸盐每增加1个月,首次静脉滴注唑来膦酸的发热风险减少23.1%。结论:既往有口服含氮双膦酸盐阿仑膦酸钠用药史者,在首次接受静脉滴注唑来膦酸5 mg治疗时,可显著减少急性炎性的发热反应发生率,即口服含氮双膦酸盐阿仑膦酸钠用药史是首次接受静脉滴注唑来膦酸发热不良反应的保护性因素。

关键词: 双膦酸盐类, 骨质疏松症, 唑来膦酸, 发热

Abstract:

Objective:To investigate the prevalence of fever after intravenous injection of  for the first time in osteoporotic patients who have or haven’t taken  bisphosphonates orally.Methods:Bone mineral density measurement was conducted of the osteoporotic patients using dual-energy X-ray absorptiometry method, and according to the WHO diagnostic criteria for osteoporosis, the patient whose T score was less than -2.5 was defined as osteoporosis. The data of 113 osteoporotic patients who received intravenous injection of  zoledronic acid in our hospital for the first time were used for analysis. Among them, 35 who had the history of oral bisphosphonates were defined as group A, and 78 who didn’t have the history of oral bisphosphonates were defined as group B (control group). Moreover, we also compared the prevalences of fever between the patients. Pearson chi-square test was used to investigate the association between oral bisphosphonates therapy and prevalence of fever, and binary logistic regression was used to analyze the impact factors of fever after intravenous injection of zoledronic acid. Results:Among the 35 patients who had the history of oral bisphosphonates, nobody had high fever, and 2 patients had low or mo-derate degree of fever (5.71%). Among the 78 patients who didn’t have the history of oral bisphosphonates, 33 patients had fever (42.3%), 15 with low fever, and 14 with moderate degree of fever, and 4 with high fever. Pearson chi-square test showed that the prevalence of fever between group A and group B had significant difference, and that differences of prevalence of fever between the outpatients and the inpatients was not statistically significant. Binary Logistic regression analysis showed that oral bisphosphonates medication history was a protective factor of fever, and with the increasing of previous oral bisphosphonates for one month, there was a reduction of fever for 23.1%. Conclusion:Patients who have the history of oral nitrogenous bisphosphonates alendronate have a significant reduction in prevalence of fever after intravenous injection of zoledronic acid for the first time. That is, oral nitrogenous bisphosphonates alendronate history is a protective factor of fever for patients with intravenous injection of zoledronic acid for the first time.

Key words: Bisphosphonates, Osteoporosis, Zoledronic acid, Fever

中图分类号: 

  • R59
[1] 张佳伟, 韩沛恩, 杨莉. 新型冠状病毒肺炎疫情分级防控水平下北京市发热门诊空间可及性[J]. 北京大学学报(医学版), 2021, 53(3): 543-548.
[2] 康磊, 徐小洁, 范岩, 王荣福, 马超, 付占立, 张建华, 张旭初. 18F-FDG PET/CT在不明原因发热中的诊断价值[J]. 北京大学学报(医学版), 2015, 47(1): 175-180.
[3] 代小秋, 刘民, 海山·卡德尔拜, 李玉玲, 杨雪松, 吴华. 北京市发热门诊63 325例就诊患者症状监测分析[J]. 北京大学学报(医学版), 2011, 43(3): 375-378.
[4] 孙慧慧, 张月华. 全面性癫(癎)伴热性惊厥附加症的分子遗传学研究进展[J]. 北京大学学报(医学版), 2008, 40(2): 229-229.
[5] 韩颖, 秦炯, 卜定方, 杨志仙, 常杏芝, 杜军保. 反复热性惊厥过程中γ-氨基丁酸B受体对一氧化氮/一氧化氮合酶体系的调节作用[J]. 北京大学学报(医学版), 2006, 38(2): 132-134.
[6] 韩颖, 秦炯, 常杏芝, 杨志仙, 杜军保. 反复热性惊厥前后硫化氢/胱硫醚-β-合成酶体系表达的改变[J]. 北京大学学报(医学版), 2005, 37(6): 579-581.
[7] 单英, 秦炯, 常杏芝, 杨志仙. 纳洛酮对幼年大鼠反复热惊厥后远期惊厥易感性的影响[J]. 北京大学学报(医学版), 2004, 36(1): 57-60.
[8] 韩颖, 秦炯, 常杏芝, 杨志仙. 发育期大鼠高热惊厥前后海马γ-氨基丁酸B受体亚基表达的变化[J]. 北京大学学报(医学版), 2003, 35(3): 288-291.
[9] 周国平, 秦炯, 常杏芝. 大鼠海马神经元血红素氧合酶-1在发育期及高热惊厥时的表达变化[J]. 北京大学学报(医学版), 2002, 34(6): 700-703.
[10] 杨志仙, 秦炯, 杜军保. 高热惊厥大鼠血红素氧合酶-1/一氧化碳体系的变化[J]. 北京大学学报(医学版), 2002, 34(6): 696-699.
[11] 游石琼, 常杏芝, 秦炯. 高热惊厥对大鼠学习行为的影响及苯巴比妥的干预效果[J]. 北京大学学报(医学版), 2002, 34(3): 234-236.
[12] 杨志仙, 秦炯, 周国平, 常杏芝. 发育期大鼠高热惊厥脑损伤模型的建立[J]. 北京大学学报(医学版), 2002, 34(3): 225-228.
[13] 缑宇轩, 吴希如. 热惊厥易感大鼠P77PMC脑组织核提取物热休克元件结合的特性[J]. 北京大学学报(医学版), 2001, 33(5): 476-477.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 田增民, 陈涛, Nanbert ZHONG, 李志超, 尹丰, 刘爽. 神经干细胞移植治疗遗传性小脑萎缩的临床研究(英文稿)[J]. 北京大学学报(医学版), 2009, 41(4): 456 -458 .
[2] 郭岩, 谢铮. 用一代人时间弥合差距——健康社会决定因素理论及其国际经验[J]. 北京大学学报(医学版), 2009, 41(2): 125 -128 .
[3] 成刚, 钱振华, 胡军. 艾滋病项目自愿咨询检测的技术效率分析[J]. 北京大学学报(医学版), 2009, 41(2): 135 -140 .
[4] 卢恬, 朱晓辉, 柳世庆, 郑杰, 邱晓彦. 白细胞介素2促进宫颈癌细胞系HeLaS3免疫球蛋白G的表达[J]. 北京大学学报(医学版), 2009, 41(2): 158 -161 .
[5] 袁惠燕, 张苑, 范田园. 离子交换型栓塞微球及其载平阳霉素的制备与性质研究[J]. 北京大学学报(医学版), 2009, 41(2): 217 -220 .
[6] 徐莉, 孟焕新, 张立, 陈智滨, 冯向辉, 释栋. 侵袭性牙周炎患者血清中抗牙龈卟啉单胞菌的IgG抗体水平的研究[J]. 北京大学学报(医学版), 2009, 41(1): 52 -55 .
[7] 董稳, 刘瑞昌, 刘克英, 关明, 杨旭东. 氯诺昔康和舒芬太尼用于颌面外科术后自控静脉镇痛的比较[J]. 北京大学学报(医学版), 2009, 41(1): 109 -111 .
[8] 祁琨, 邓芙蓉, 郭新彪. 纳米二氧化钛颗粒对人肺成纤维细胞缝隙连接通讯的影响[J]. 北京大学学报(医学版), 2009, 41(3): 297 -301 .
[9] 李宏亮*, 安卫红*, 赵扬玉, 朱曦. 妊娠合并高脂血症性胰腺炎行血液净化治疗1例[J]. 北京大学学报(医学版), 2009, 41(5): 599 -601 .
[10] 李伟军, 邢晓芳, 曲立科, 孟麟, 寿成超. PRL-3基因C104S位点突变体和CAAX缺失体的构建及表达[J]. 北京大学学报(医学版), 2009, 41(5): 516 -520 .