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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2021-21-2-102-109</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-6641</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>РЕВМАТОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>RHEUMATOLOGY</subject></subj-group></article-categories><title-group><article-title>Роль золедроновой кислоты в лечении остеопороза и профилактике переломов</article-title><trans-title-group xml:lang="en"><trans-title>Role of zoledronic acid in treatment of osteoporosis and prevention of fractures</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9722-1285</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кривова</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Krivova</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кривова Алла Владимировна – доктор медицинских наук, доцент, профессор кафедры травматологии и ортопедии.</p><p>170100, Тверь, ул. Советская, д. 4.</p></bio><bio xml:lang="en"><p>Alla V. Krivova - Dr. Sci. (Med.), Professor of the Department of Traumatology and Orthopedics, Tver State Medical University.</p><p>4, Sovetskaya St., Tver, 170100.</p></bio><email xlink:type="simple">krivova267@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9345-0291</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Захаров</surname><given-names>В. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Zakharov</surname><given-names>V. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Захаров Валерий Петрович – кандидат медицинских наук, заведующий кафедры травматологии и ортопедии.</p><p>170100, Тверь, ул. Советская, д. 4.</p></bio><bio xml:lang="en"><p>Valeryi P. Zakharov - Cand. Sci. (Med.), Head of the Department of Traumatology and Orthopedics, Tver State Medical University.</p><p>4, Sovetskaya St., Tver, 170100.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3369-9519</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шаров</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Sharov</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шаров Александр Николаевич - ассистент кафедры травматологии и ортопедии.</p><p>170100, Тверь, ул. Советская, д. 4.</p></bio><bio xml:lang="en"><p>Alexander N. Sharov - Assistant of the Department of Traumatology and Orthopedics, Tver State Medical University.</p><p>4, Sovetskaya St., Tver, 170100.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Тверской государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Tver State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>09</day><month>01</month><year>2022</year></pub-date><volume>0</volume><issue>21-2</issue><fpage>102</fpage><lpage>109</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Кривова А.В., Захаров В.П., Шаров А.Н., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Кривова А.В., Захаров В.П., Шаров А.Н.</copyright-holder><copyright-holder xml:lang="en">Krivova A.V., Zakharov V.P., Sharov A.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/6641">https://www.med-sovet.pro/jour/article/view/6641</self-uri><abstract><sec><title>Введение</title><p>Введение. Одной из причин первичной инвалидности и высокой летальности среди больных остеопорозом являются переломы, возникшие при минимальной травме, как правило, в результате падения с высоты собственного роста. Конечным звеном в цепи профилактических мероприятий по снижению частоты остеопороза и переломов на его фоне является внедрение в практическую деятельность ортопеда-травматолога фармакологической коррекции дефицита костной ткани. В настоящее время существует ряд препаратов, способных изменить нарушенный метаболизм. Например, использование препарата золедроновой кислоты достоверно снижает риск переломов.</p></sec><sec><title>Цель</title><p>Цель: изучить влияние золедроновой кислоты на минеральную плотность кости у больных остеопорозом, осложненным переломом проксимального отдела бедра.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В проведенном когортном проспективном исследовании 14 пациенток получали золедроновую кислоту в течение 2 лет.</p></sec><sec><title>Результаты</title><p>Результаты. При сравнении минеральной плотности костной ткани (МПК) L2-L4 (поясничного отдела) выявлено, что спустя год от начала лечения ее увеличение относительно базового значения составило 4,6%, что было статистически незначимо (0,86 ± 0,078 г/см2 против 0,90 ± 0,08 г/см2, р &gt; 0,05). После 2 лет лечения МПК данного сегмента увеличилась относительно базовых значений на 12% и различия стали статистически значимыми (0,86 ± 0,078 г/см2 против 0,97 ± 0,076 г/см2, p &lt; 0,05). Прирост МПК за 2-й год лечения на 6% статистически значимо отличался от прироста за 1-й год лечения (0,90 ± 0,08 г/см2 против 0,97 ± 0,076 г/см2, р &lt; 0,05).</p><p>Сравнительный анализ базовых величин МПК шейки бедра спустя 1-й и 2-й годы лечения не выявил достоверных различий: 0,7075 ± 0,046 г/см2 против 0,7079 ± 0,034 г/см2 и 0,70751 ± 0,046 г/см2 против 0,6630 ± 0,97 г/см2, р &gt; 0,05. Ни в одном случае за 2 года не отмечены новые переломы тел позвонков, только у одной пациентки наблюдался перелом лучевой кости в дистальной трети. Спустя 2 года лечения качество жизни пациенток достоверно улучшилось по шкале «привычная повседневная деятельность» (р = 0,007), снизились показатели по шкале «тревога» и «депрессия» (р &gt; 0,05).</p></sec><sec><title>Обсуждение</title><p>Обсуждение. В исследовании было получено подтверждение, что даже при наличии выраженной потери костной массы фармакологическая коррекция нарушенного ремоделирования снижает риск новых переломов и улучшает качество жизни.</p></sec><sec><title>Выводы</title><p>Выводы. Фармакотерапия золедроновой кислотой в лечении остеопороза и профилактики переломов подтвердила свою эффективность.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. One of the causes of primary disability and high mortality, among patients with osteoporosis, are fractures that occur with minimal trauma, as a rule, it is a fall from the height of one’s own height. The final link in the chain of preventive measures to reduce the frequency of osteoporosis and fractures on its background is the introduction of pharmacological correction of bone deficiency into the practical activity of an orthopedic traumatologist. Currently, there are several drugs that can change the disturbed metabolism. For example, the use of zoledronic acid significantly reduces the risk of fractures.</p></sec><sec><title>Aim</title><p>Aim: to study the effect of zoledronic acid on bone mineral density in patients with osteoporosis complicated by a fracture of proximal end of the femur.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. In a prospective cohort study, 14 patients received zoledronic acid for 2 years.</p></sec><sec><title>Results</title><p>Results. When comparing BMD L2-L4, it was revealed that a year after the start of treatment, its increase relative to the baseline value was 4.6%, but was statistically insignificant (0.86 ± 0.078 g/cm2 versus 0.90 ± 0.08 g/cm2, p &gt; 0.05). After 2 years of treatment, the BMD of this segment increased, relative to the baseline values, by 12% and the differences became statistically significant (0.86 ± 0.078 g/cm2 compared to 0.97 ± 0.076 g/cm2, p &lt; 0.05). The increase in BMD for the second year of treatment by 6% was statistically significantly different from the increase for the first year of treatment (0.90 ± 0.08 g/cm2 compared to 0.97 ± 0.076 g/cm2, p &lt; 0.05).</p><p>A comparative analysis of the basic units of the IPC hip after 1 and 2 years of treatment did not reveal significant differences: 0.7075 ± 0.046 g/cm2 compared to 0.7079 ± 0.034 g/cm2 and 0.70751 ± 0.046 g/cm2 compared to 0.6630 ± 0.97 g/cm2, p &gt; 0.05. In any case, for 2 years not marked new vertebral body fractures. Only one patient had a fracture of the radius in the distal third. The quality of life, after 2 years, significantly improved on the scale of “habitual daily activities” (p = 0.007), decreased indicators on the scale of “anxiety” and “depression” (p &gt; 0.05).</p></sec><sec><title>Discussion</title><p>Discussion. The study confirmed that even in the presence of pronounced bone loss, pharmacological correction of impaired remodeling reduces the risk of new fractures and improves the quality of life.</p></sec><sec><title>Conclusion</title><p>Conclusion. Pharmacotherapy with zoledronic acid, in our study, confirmed its effectiveness in the treatment of osteoporosis.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>остеопороз</kwd><kwd>золедроновая кислота</kwd><kwd>лечение</kwd><kwd>профилактика</kwd><kwd>низкотравматические переломы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>osteoporosis</kwd><kwd>zoledronic acid</kwd><kwd>treatment</kwd><kwd>prevention</kwd><kwd>low energy fractures</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Kanis J.A. Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2002;359(9321):1929–1936. https://doi.org/10.1016/S0140-6736(02)08761-5.</mixed-citation><mixed-citation xml:lang="en">Kanis J.A. Diagnosis of osteoporosis and assessment of fracture risk. 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