中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2021, Vol. 19 ›› Issue (1): 59-63.doi: 10.19438/j.cjoms.2021.01.012

• 临床总结 • 上一篇    下一篇

不同临床分期二膦酸盐颌骨骨髓炎的临床特点及其治疗：附16例报告

郭艳红, 叶斯哈提·木合塔尔, 李红, 孙杨, 龚忠诚   

  1. 新疆医科大学第一附属医院（附属口腔医院） 口腔颌面肿瘤外科, 新疆维吾尔自治区口腔医学研究所,新疆 乌鲁木齐 830054
  • 收稿日期:2020-04-15 修回日期:2020-07-13 出版日期:2021-01-20 发布日期:2021-02-19
  • 通讯作者: 龚忠诚,E-mial：gump0904@hoo.com.cn
  • 作者简介:郭艳红（1993-）,女,在读硕士研究生,E-mial：1584404800@qq.com

Clinical characteristics and treatment of bisphosphonate jaw osteomyelitis in different clinical stages: a report of 16 consecutive cases

GUO Yan-hong, YESIHATI·Muhetaer, LI Hong, SUN Yang, GONG Zhong-cheng   

  1. Department Oromaxillofacial Carcinoma Surgery, First Affiliated Hospital & Stomatological Hospital of Xinjiang Medical University. Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Received:2020-04-15 Revised:2020-07-13 Online:2021-01-20 Published:2021-02-19

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摘要： 目的: 分析二膦酸盐颌骨骨髓炎（bisphosphonate related osteonecrosis of the jaw, BRONJ）的临床特点及相关检查结果,为临床预防提供依据。方法: 回顾分析2013—2019年就诊于新疆医科大学第一附属医院和新疆维吾尔自治区人民医院被确诊为BRONJ的16例患者的病例资料,包括一般资料、实验室检查、影像学检查等。采用SPSS 24.0软件包对数据进行统计学分析。结果: 16例患者中,男6例 （37.5%）,女10例（62.5%）;15例有原发肿瘤,1例为骨质疏松。其中使用二磷酸盐（BPs）类药物时间<12个月4例（25%）、12~36个月8例（50%）、≥36个月4例（25%）。16例BRONJ患者的临床分期为Ⅱ期或Ⅲ期。使用BPs药物时间与BRONJ分期之间比较,差异有统计学意义（P<0.05）。使用BPs药物后出现临床症状到就诊时间与BROBJ分期之间比较、使用BPs药物时间与实验室检查结果比较,差异均无统计学意义（P>0.05）。骨密度测量发现,BPs组在2个区域的骨密度均显著高于化脓性颌骨骨髓炎组和健康组（P<0.05）,而化脓性颌骨骨髓炎组和健康组之间骨密度无显著差异（P>0.05）。结论: 使用BPs类药物的时间越长,BRONJ的感染程度越重。骨密度差异表明,使用BPs药物后骨松质的骨密度明显升高,更容易发生颌骨骨坏死。

关键词: 二膦酸盐, 颌骨骨髓炎, 化脓性颌骨骨髓炎

Abstract: PURPOSE: The clinical characteristics and relevant examinations of bisphosphonate related osteonecrosis of the jaw（BRONJ）were analyzed in order to provide a basis for clinical prevention. METHODS: Retrospective analysis of 16 patients diagnosed with BRONJ in the First Affiliated Hospital of Xinjiang Medical University and Xinjiang Uygur Autonomous Region People's Hospital from 2013 to 2019, including general data, laboratory and imaging examination was performed. SPSS 24.0 software package was used for statistical analysis of the data. RESULTS: Among 16 patients, there were 6 males (37.5%) and 10 females(62.5%). There were primary tumors in 15 patients and osteoporosis in 1 patient. Among them, 4(25%) patients used bisphosphonates (BPs) for less than twelve months, 8(50%) patients for 12-36 months, and 4(25%) patients used bisphosphonates (BPs) for more than or equal to 36 months. Sixteen patients were at stage Ⅱ or Ⅲ. There was a significant difference between the time of using BPs and BRONJ stages(P<0.05). There was no significant difference between the time to visit for clinical symptoms after using BPs and the stage of BROBJ, and the time between the use of BPs and the laboratory test results(P>0.05). Bone mineral density measurement showed that bone density of BPs group in both regions was significantly higher than suppurative jaw osteomyelitis group and the healthy controls(P<0.05). There was no significant difference in bone mineral density between healthy group and suppurative jaw osteomyelitis group (P>0.05). CONCLUSIONS: The results suggest that the longer the time of using BPs, the more severe the BRONJ infection. Bone mineral density increased significantly after the use of BPs, and osteonecrosis of jaw bone was more likely to occur.

Key words: Bisphosphonate, Oteomyelitis of jaw, Suppurative jaw osteomyelitis

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