目的：探讨特立帕肽对胸腰椎压缩性骨折（TLCF）患者多模态影像学参数及骨微环境的改善效果。方法：研究对象选择2024年3月~2025年3月至我院行经皮椎体后凸成形术（PKP）治疗的109例TLCF患者，通过随机数字表法将其列为常规组（54例）、试验组（55例）。常规组术后实施常规药物治疗，试验组术后采用特立帕肽联合常规药物治疗，治疗周期为6个月，于治疗1个月后比较两组患者的骨微环境，症状及功能。于治疗6个月后比较两组患者的多模态影像学参数及短期预后情况，于治疗期间统计并对比两组治疗安全性。结果：治疗1个月后，试验组的骨钙素（OC）、骨特异性碱性磷酸酶（BALP）、Ⅰ型原胶原N端前肽（PⅠNP）、Ⅰ型原胶原C端前肽（PⅠCP）分别为（12.42±3.31）ng/mL、（7.02±1.55）μg/L、（25.19±5.46）ng/mL、（68.22±6.47）ng/mL，均高于常规组[（10.39±2.45）ng/mL、（5.77±1.29）μg/L、（21.41±4.33）ng/mL、（63.19±5.27）ng/mL]（t=3.634，4.572，4.000，4.446；P＜0.05）。试验组的视觉模拟疼痛量表（VAS）评分、Oswestry功能障碍指数（ODI）评分均低于常规组（t=6.096，2.754；P＜0.05）。治疗6个月后，试验组的面积骨密度（aBMD）、骨小梁评分（TBS）、预估椎体强度（EVS）分别为（0.75±0.11）g/cm2、（1.29±0.22）、（2.33±0.42）MPa，均高于常规组[（0.51±0.08）g/cm2、（0.82±0.13）、（1.62±0.25）MPa]，骨髓脂肪分数（MFF）（38.48±5.24）%低于常规组（43.19±6.33）%（t=13.007，13.547，10.670，4.235；P＜0.05）。试验组的不良预后发生率10.91%（6/55）低于常规组27.78%（15/54）（x2=4.985；P＜0.05）。试验组治疗期间的药物相关副反应发生率与常规组比较，差异无统计学意义（P＞0.05）。结论：特立帕肽可改善TLCF患者PKP术后骨微环境及疼痛症状、功能障碍，可在避免增加治疗风险同时，有效促进多模态影像学参数恢复，并降低不良预后发生风险。

Objective:To explore the improvement effect of teriparatide on multimodal imaging parameters and bone microenvironment in patients with TLCF.Methods:The research subjects selected 109 patients with TLCF who underwent PKP treatment at our hospital from March 2024 to March 2025. They were randomly divided into a control group (54 cases) and an experimental group (55 cases) using a random number table method. The control group received conventional drug treatment after surgery, while the experimental group received a combination of teriparatide and conventional drug treatment after surgery, with a treatment period of 6 months. After 1 month of treatment, the bone microenvironment, symptoms, and function of the two groups of patients were compared. Compare the multimodal imaging parameters and short-term prognosis of the two groups of patients after 6 months of treatment, and compare the safety of the two groups during the treatment period.Results:After one month of treatment, the levels of OC, BALP, PⅠNP, and PⅠCP in the experimental group were (12.42 ± 3.31) ng/mL, (7.02 ± 1.55) μg/L, (25.19 ± 5.46) ng/mL, and (68.22 ± 6.47) ng/mL, higher than the control group [(10.39 ± 2.45) ng/mL, (5.77 ± 1.29) μg/L, (21.41 ± 4.33) ng/mL, and (63.19 ± 5.27) ng/mL] (t=3.634，4.572，4.000，4.446; P<0.05). The VAS score and ODI score of the experimental group were lower than the control group (t=6.096，2.754; P<0.05). After 6 months of treatment, the aBMD, TBS, and EVS of the experimental group were (0.75 ± 0.11) g/cm2, (1.29 ± 0.22), and (2.33 ± 0.42) MPa, higher than the control group [(0.51 ± 0.08) g/cm2 (0.82 ± 0.13), and (1.62 ± 0.25) MPa], and the MFF was (38.48 ± 5.24)% lower than that of the control group (43.19 ± 6.33)% (t=13.007，13.547，10.670，4.235; P<0.05). The incidence of poor prognosis in the experimental group was 10.91% (6/55) lower than the control group, which was 27.78% (15/54) (x2=4.985; P<0.05). The incidence of drug-related side effects during the treatment period in the experimental group was similar to the control group (P>0.05).Conclusion:Teriparatide can improve the bone microenvironment, pain symptoms, and functional impairment in patients with TLCF after PKP surgery. It can effectively promote the recovery of multimodal imaging parameters while avoiding increased treatment risks, and reduce the risk of adverse prognosis.