Comparative Analysis Of Acute Phase Reaction After Intravenous Zoledronic Acid In Conservative Treatment And Operative Treatment For Osteoporosis Fractures

Objective:To investigate the characteristics and variabilities of the acute phase response after intravenous Zoledronic acid in conservative treatment and operative treatment for thoracolumbar postmenopausal osteoporosis fractures. Methods:A total of 70 patients who were treated in the Second Affiliated Hospital of Jilin University from January 2013 to December 2015 with postmenopausal osteoporosis fractures were selected. The patients were divided into conservative treatment group( Group A, GA) and operative treatment group(Group B, GB). The age, the age of menopause, BMI, BMD, acute phase response and laboratory parameters between the two groups were compared and analyzed. Results:A total of 70 patients who met the inclusion criteria and suffered with postmenopausal osteoporosis fractures were collected. 38 cases were treated by conservative treatment and 32 cases were treated by operative treatment. In conservative treatment group, the average age was(63.21±6.54) years, the average age of menopause was(49.79±3.88) years, the BMI was(23.80±1.86) kg/m2, the BMD was-5.42±1.47. In operative treatment group, the average age was(60.66±4.76) years, the average age of menopause was(50.88±3.41) years, the BMI was(24.50±2.13) kg/m2, the BMD was-5.19±1.31. According to the statistical results, there was no significant difference of general information between two groups( P305.0). In GA, a total of 38 patients were eligible for inclusion in the study, of which 18(47.37%) patients experienced APR. There were 18(47.37%) patients developed fever, 3(7.89%) patients had flu-like symptoms, and 1(2.63%) patient suffered from muscular soreness. In GB, a total of 32 patients were eligible for inclusion in the study, of which 25(78.13%) patients experienced APR. There were 25(78.13%) patients developed fever, 12(37.50%) patients had flu-like symptoms, 2(6.25%) patients suffered from muscular soreness, and 2(6.25%) patients suffered from arthralgia. The incidence of fever and flu-like symptoms after intravenous Zoledronic acid in GB was much higher than those in GA( P(27)05.0). The difference of the leukocyte count, the neutrophils count and percent, the lymphocyte count and percent, the monocytes count and percent in GB was much higher than those in GA( P(27)05.0). After intravenous Zoledronic acid, there was no significant difference of serum phosphate, creatinine and urea nitrogen between two groups( P305.0). While, the difference of alkaline phosphatase and serum calcium in GB was much higher than that in GA( P(27)05.0). Conclusion:The incidence of APR after the intravenous injection of Zoledronic acid to treat postmenopausal osteoporosis fractures was high for the first time. Although the symptoms of APR were temporary, the symptomatic treatment was needed. After intravenous injection of Zoledronic acid, the incidence and intensity of adverse reaction in GB were significantly higher than those in GA.The recovery period should be prolonged after operation, and the treatment of osteoporosis with double phosphate and other drugs could be done.