内科学（继教）PPT课件 第七篇 内分泌及代谢疾病11第十一章 骨质疏松症.ppt

骨质疏松可以由多种原因导致。绝经是骨质疏松最常见的原因。骨质疏松最根本的发生机制是体内骨转换不平衡，导致骨吸收超过骨形成。原发性骨质疏松的治疗要点是：①调整生活方式；②补充钙和维生素D；③使用破骨细胞抑制剂或/和促成骨剂。 第十一章 骨质疏松 小结 第十一章 骨质疏松 谢谢观看 THANKS 审稿意见：多处“骨质疏松”，是否应该改成“骨质疏松症” Supplemental Information The osteoclast is the only bone resorbing cell, and is derived primarily from bone marrow granulocyte macrophage-colony forming units.2 Osteoclasts resorb bone by attaching to the bone matrix, polarizing, and forming a sealing zone at the bone surface that creates an isolated resorption compartment.2 Activated osteoclasts secrete hydrochloric acid and collagen-degrading enzymes onto the bone surface, resulting in bone mineral dissolution and organic matrix degradation.2 After detaching from the organic matrix, the osteoclast can either relocate and begin resorption at another site on the bone surface (as shown in the electron micrograph above), or undergo apoptosis.2 Electron micrograph obtained from The Bone Research Society. .uk/gallery/arnett_osteoclast.jpg Accessed 2/19/2009. Bar-Shavit Z. J Cell Biochem. 2007;102:1130-1139. Bar-Shavit Z, et al. J Cell Biochem. 2007;102:1131,A,2;1131,Fig1;1132,A,3 Bar-Shavit Z, et al. J Cell Biochem. 2007;102: 1132,A,3;B,1;;fig 2 Supplemental Information Bone remodeling is the process by which old bone is replaced by new bone and consists of 4 phases: activation, resorption, reversal, and formation.2,3 Activation: Resting bone surface is converted to a remodeling surface during activation of the bone remodeling process.2,3 Recruitment of osteoclast precursors to the bone lining cell layer and their differentiation into mature, active osteoclasts occurs.2,3 Resorption: Osteoclasts remove both mineral and organic components of bone matrix by generating an acidic microenvironment between the cell and bone surface.2 The resorbing surface has a scalloped, eroded appearance known as Howship’s or resorption lacunae.3 After resorption, osteoclasts either go through apoptosis or leave the resorption site.2 Reversal: This phase begins