系统性红斑狼疮的骨质疏松与皮质激素的相关性.pptxVIP

GC induced osteoporosis 北京协和医院风湿免疫科 张 烜IntroductionGCs are effective in many rheumatic diseases But GC induced OP is a common side effectTrabecular rich sites eg spine ribs are especially at riskEffective Rx can prevent or reverse GC bone lossOP in RA on GC Rx多因素RAOsteoclast 活化 ( TNFa，RANK)Physical inactivityGC RxMenopause 不同部位骨丢失不同Hand Femur Spine腰椎骨丢失与GC强相关PathophysiologyMost of the biological activities mediated viaPassage across cell membrane attachment to cytosolic GC receptor binding to GC response element regulating gene transcriptionMay act via other transcription factors:acti