| 于龙,王亮.老年骨质疏松症现状及进展[J].中国临床保健杂志,2022,25(1):6-11. |
| 老年骨质疏松症现状及进展 |
| Status and progress of osteoporosis in the elderly |
| 投稿时间：2021-12-21 |
| DOI：10.3969/J.issn.1672-6790.2022.01.002 |
| 中文关键词: 骨质疏松 骨密度 药物疗法 骨密度保护剂 老年人 |
| 英文关键词: Osteoporosis Bone density Drug therapy Bone density conservation agents Aged 〖FL |
| 基金项目: |
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| 中文摘要: |
| 老年性骨质疏松症以骨矿含量下降,骨微细结构破坏为病理特征。男性峰值骨量高于女性,出现骨丢失的年龄迟于女性,而且雄激素水平的下降是“渐进式”,而非“断崖式”,故老年男性骨丢失的量与速度都低于老年女性,老年男性骨质疏松的程度轻于女性。老年骨质疏松症的诊断基于全面的病史采集、体格检查、骨密度测定、影像学检查(X线及QCT)及必要的生化测定。在使用基础用药的基础上(钙剂和维生素D),治疗骨质疏松症的药物可分为抑制骨吸收药物和促骨形成药物。抑制骨吸收药物包括双膦酸盐、雌激素替代疗法、选择性雌激素受体调节剂(SERM)、地舒单抗、降钙素等等。促骨形成药物包括甲状旁腺激素(PTH)类似物和骨硬化蛋白抑制剂。序贯和组合使用抗骨质疏松药物,例如从促骨形成药物转换为抑制骨吸收药物,可能提高抗骨质疏松疗效。该文将总结老年性骨质疏松症的流行病特点、分子机制、诊断、目前治疗骨质疏松症的药物及联合或序贯用药策略。 |
| 英文摘要: |
| Senile osteoporosis is characterized by decreased bone mineral content and destruction of bone microstructure.Because the peak bone mass of men is higher than that of women and the age of bone loss is later than that of women,the amount and speed of bone loss in elderly men are lower than those in the elderly women.The diagnosis of senile osteoporosis is based on comprehensive medical history collection,physical examination,bone density measurement,imaging examination (X-ray and QCT) and necessary biochemical measurements.Based on the use of basic medications (calcium and vitamin D),Anti-resorptive agents that inhibit bone resorption,such as bisphosphonates,estrogen replacement therapy,selective estrogen receptor modulators (SERM),desulumab,calcitonin and anabolic drugs that stimulate bone formation,including PTH analogues and sclerostin inhibitors,are current treatments for osteoporosis.Sequential or combined use of anti-osteoporosis drugs,such as switching from anabolic drugs to anti-resorptive agent,may improve the efficacy of anti-osteoporosis.This review will summarize the epidemiological characteristics,molecular mechanisms,diagnosis,current treatments of osteoporosis,and combined or sequential drug strategies for senile osteoporosis. |
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