骨质疏松症内科讲课课件_1.pptVIP

甲状旁腺素制剂 小剂量、间歇应用 有效促进骨形成 增加骨密度 降低骨折发生率 注射给药 继发性骨质疏松症的治疗概述 积极治疗原发病 去除或减少骨质疏松症的影响因素 尽早开展药物防治 钙剂 活性维生素D:1,25(OH)D3，1?OHVITD3 双膦酸盐类药物 降钙素类 监测血尿生化指标 BMD X光片 骨质疏松症的生活干预 坚持锻炼 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 d