课件：骨质蔬松.ppt

* 我们从维生素D的代谢途径可以看出，具有1、25位两个羟基的1,25(OH)2D3是维生素D在人体内的最高活性形式。普通维生素D3需经过肝脏和肾脏羟化酶激活才能起效，而1α(OH) D3虽然不需要肾脏羟化，但仍需经过肝脏25－羟化酶羟化激活才能起效；罗盖全无需肝肾羟化激活即具有最高活性，可直接起效，免去中间代谢周折，是真正的活性维生素D3。 * 罗盖全卓著的疗效和安全性还源自于独特的药代动力学特性。 * 这是6名健康人分别口服同等剂量的罗盖全和1α(OH) D3后，血液中1,25(OH)D3浓度曲线比较。图中红线代表罗盖全，绿线代表1α(OH) D3，从中我们可以看到罗盖全在用药后2小时即可达到血药浓度峰值，起效直接，迅速，而1α(OH) D3 服用后达到有效浓度的时间长，起效较慢。罗盖全血药浓度达到峰值后又能快速下降，半衰期仅为9－10小时，一旦因用药过量引起高血钙，则停用罗盖全后能很快缓解；而1α(OH) D3的药物半衰期较长，容易在人体内蓄积，出现高血钙时也较难缓解。因此，罗盖全具有更高的安全性。 剂型与包装 剂型：0.25 μg软胶囊 包装：10粒棕色瓶装 小 结 罗盖全无需肝肾羟化激活，直接起效，活性最强 直击肾性骨病关键环节，多管齐下，全方位调控 有效控制继发性甲旁亢，改善骨组织学病理表现 疗效不受肝功能影响，对肝脏易损的血透患者尤其重要 罗盖全是治疗肾性骨病的首选用药 谢 谢！ THANK YOU SUCCESS * * 可编辑 * * According to the NIH Consensus Statement, bone strength reflects the integration of bone quality and bone density. Bone density is expressed as grams of mineral per area or volume. Bone quality refers to architecture, turnover, damage accumulation, and mineralization.1 1NIH Consensus Development Panel. JAMA. 2001;285:785-795. * These images illustrate the microarchitecture of vertebrae of normal bone, osteoporosis and severe osteoporosis. In the normal bone, note the perpendicular orientation between the horizontal and vertical trabeculae. This interconnectivity of the three-dimensional lattice of the trabeculae makes the vertebral bodies particularly well suited to support compressive loads. In the osteoporotic vertebrae, one sees loss of connectivity, with interrupted or truncated rods, and thinning of trabecular plates. Note that the loss of horizontal or lateral struts occurs before loss of vertical struts, resulting in reduced load-bearing capacity, decreased bone strength and a greater susceptibility to fracture. This helps us understand why the definition of osteoporosis includes a reference to both a loss in mass or bone density as well as microarchitectural deterioration. * Slide: Speaker Notes: This slides provides a graphic demonstration of the Euler Buckling Theory. A vertical column will buckle, at a cri