骨质疏松症的诊断与治疗北京协和医院—培训课件.pptVIP

减少饮酒、含咖啡因饮料 停止抽烟 尽量减少影响骨骼代谢的药物，避免摔跤 Thank you! 统计资料显示美国在1996年，骨质疏松性骨折的年发生数约为150万人，心脏病发作为51万、中风23万，乳腺癌的年发病为18万。由此可见骨质疏松症的危害性。 The first sign of a clinical vertebral fracture is usually the sudden onset of back pain with little or no trauma, leaving all the chronic manifestations of spine fracture (loss of height, spinal deformity/dowager’s hump, protuberant abdomen). Osteoporotic fractures lead to decreased activity, which perpetuates bone loss. Pulmonary disorders are also a major complication of vertebral fractures. One thoracic vertebral compression fracture causes a 9% loss of forced vital capacity, and lumbar fractures have also been linked to impairment of pulmonary function. The beginning of a vertebral kyphosis predisposes to other fractures, resulting in an almost 12-fold increased risk for new vertebral fractures with 2 or more previous fractures. Ross PD et al, Davis JW, Epstein RS, et al. Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med 1991;114;919-23. Silverman SL. The clinical consequences of vertebral compression fracture. Bone 1992;13 (suppl 2):S27-S31. Cooper C, Atkinson EJ, Jacobsen SJ, et al. Population-based study of survival after osteoporotic fractures. Am J Epidem 1993;137:1001-5. Lyles KW, Gold DT, Shipp KM, et al. Association of osteoporotic vertebral compression fractures with impaired functional status. Am J Med 1993;94:595-601. Schlaich C, Minne HW, Bruckner T, et al. Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporosis Int 1998;8:261-7. The first step of remodeling is activation of resorption. Cells that line bone surfaces retreat, allowing the osteoclasts to resorb exposed tissue, creating “pits.” Following the reversal stage, osteoblasts lay down new osteoid matrix, which mineralizes. Bone formation continues for several months. Keywords: bone remodeling, resorption, bone formation The NIH consensus document (JAMA, 2001) emphasizes bon