To investigate the effect of tripartide combined with bisphosphonate on type I procollagen N-terminal propeptide (PINP) and type I collagen C-terminal peptide (CTX-1) in patients with osteoporosis after senile vertebral compression fracture.

A total of 44 senile osteoporotic patients with vertebral compression fracture treated in our hospital between September 2017 and March 2018 were selected. According to the order of admission, they can be divided into group A (24 cases) and group B (20 cases). In addition, the group C (20 cases) was selected as the patients who did not receive treatment due to intolerance of postoperative drug therapy. Group A was treated with tripeptide+bisphosphonate (zoledronic acid)+ calcium (calqid chewable tablets), and group B was treated with vitamin D+calqid chewable tablets and followed up for 12 months. The follow-up and operation of the three groups were recorded. The visual analogue pain score (VAS), Oswestry dysfunction index (ODI), bone mineral density (BMD), (lumbar L1-4), serumPINP, CTX-1, adverse reactions and the incidence of re-fracture were observed and compared among thethree groups at different time points.

All 64 patients were followed up completely with a follow-up rate of 100% and a follow-up time of 12-19 months, with an average of (13.82±1.24) months, of which group A was followed up for 12-18 months, with an average of (13.57±1.17) months. Group B was followed up for 13 to 22 months, with an average of (14.23±1.29) months. Group C was followed up for 12 to 20 months, with an average of (13.71±1.20) months. The average operation time of 64 patients was (17.63±2.04) min, the bone cement perfusion volume was 3-7 mL, and the average was (3.32±0.46) mL. Twelve patients (18.75%) had bone cement leakage after operation, including 5 cases in group A, 4 cases in group B, and 3 cases in group C.At 3 months, 6 months, 9 months and 12 months after treatment, the scores of VAS in group A were (3.06±1.12), (1.82±0.74), (1.52±0.54), (1.41±0.49) respectively. ODI index were (28.42±5.16), (21.64±4.92), (18.76±4.52), (17.59±4.38) respectively. The scores of VAS in group B were (3.81±1.28), (3.19±1.13), (2.76±0.97), (2.53±0.85) respectively. ODI index was (34.58±6.13), (31.27±5.86), (28.48±5.34), (27.94±5.17) respectively. The scores of VAS in group C were (4.51±1.42), (4.16±1.49), (3.98±1.31), (3.59±1.24) respectively. ODI index was (37.71±6.54), (35.48±6.07), (33.97±5.87), (33.61±5.80) respectively. The score of VAS and ODI index in group A at 3 months, 6 months, 9 months and 12 months after treatment were significantly lower than those in group B and group C (P<0.05). At 3 months after treatment, the difference between group B and group C was not significant (P>0.05). At 6 months, 9 months and 12 months after treatment, the difference was significantly lower than that of group C (P<0.05). The levels of BMD, PINP and CTX-1 in group A were [(0.835±0.103)g/cm², (134.08±27.29)ng/mL, (216.85±26.63)μg/L], higher than [(0.774±0.076)g/cm², (93.57±19.85)ng/mL, (216.85±26.63)μg/L] in group B and [(0.706±0.051)g/cm², (49.74±10.59)ng/mL, (161.05±15.42)μg/L] in group C, and all indexes in group B were significantly higher than those in group C (all P<0.05). During the follow-up period, There were no patients with refracture in group A, the incidence of refracture in group B was 5.00%, and the incidence of refracture in group C was 15.00%, but there was no significant difference among the three groups (P>0.05).

Telipatide combined with bisphosphonate has a significant clinical effect on senile osteoporotic patients after vertebral compression fracture surgery. It can effectively improve BMD, improve bone synthesis and bone absorption index level, significantly reduce pain and related dysfunction, and has high safety, which is worthy of promotion.