尿生化指标对原发性骨质疏松症的诊治体会

骨质疏松症是一种以低骨量和骨组织微结构破坏为特征,导致骨脆性增加和容易发生骨折的全身性疾病。多数学者认为骨质疏松症的主要病理生理机制是破骨细胞所介导的骨吸收增加,骨转换增高。本文通过测定原发性骨质疏松症患者药物治疗前后四种尿生化指标,比较其对原发性骨质疏松症治疗的评价效果。     

浅论绝经后骨质疏松与失重性骨质疏松的中医辨证治疗比较

骨质疏松症(osteoporosis,OP)是一种以骨量和骨组织微结构破坏为特征,导致骨脆性增加和容易发生骨折的全身性骨骼疾病.中医学中并无"骨质疏松症"一名,而根据骨与骨质疏松症相互关系、病理变化和症状描述等,将其归入"骨痿"范畴.笔者选择了绝经后骨质疏松和失重引起骨质疏松两种骨质疏松症,总结前人工作成果,进行中医药辨证与干预措施的比较.     

男性老年性骨质疏松症的诊治和预防

男性骨质疏松症包括以下几种类型：男性老年性骨质疏松症、男性特发性骨质疏松症和男性继发性骨质疏松症。本节将着重讨论男性老年性骨质疏松症的诊治和预防。１　男性骨量变化的特点男性与女性相似,自青春期开始骨量显著增加,中年以后,骨量逐渐减少。但男性骨峰值形成期的持续时间较女性为长,总体骨架较女性大,长骨的直径、长骨皮质骨的厚度、椎体和股骨颈部位的截面面积均大于女性。由于长骨的直径是其强度的主要决定因素,而男性长骨直径和皮质骨厚度较大,所以男性的长骨的强度高于女性,不易发生骨折。有人报道,青年男性总的骨矿…     

妊娠及哺乳期新一代骨代谢指标与骨密度测量的研究进展

<正>骨质疏松症(Osteoporosis,OP)为一种以骨量减少、骨的微结构破坏为特征,导致骨强度损害、骨折危险性增加的代谢性骨病。骨质疏松症分为原发性,继发性和特发性骨质疏松症三种类型。特发性骨质疏松症,是原因不明的一类骨质疏松症。妊娠及哺乳期女性所发生的骨质疏松属于特发性骨质疏松。     

绝经期妇女骨质疏松症综合治疗

骨质疏松症是绝经期妇女的常见病、多发病。其主要原因是绝经后的妇女体内雌激素水平下降,导致的骨吸收加快,骨量减少,骨密度下降,有研究者统计,绝经前后骨密度值有显著查异〔1〕。随着我国人口老龄化,骨质疏松症的患病率也呈上升趋势。骨质疏松症的最主要的并发症是骨关节病和     

骨质疏松症

骨质疏松症主要分为原发性骨质疏松症与继发性骨质疏松症两大类。原发性骨质疏松症包括女性绝经后骨质疏松症(Ⅰ型)和老年退化性骨质疏松症(Ⅱ型) ;继发性骨质疏松症则由许多后天性因素诱发所致,包括物理和力学因素,内分泌疾患,肾病、类风湿、消化系统疾病导致的吸收不良,以及肿瘤等。这里我们主要对原发性骨质疏松症进行阐述。1　骨质疏松症的定义原发性骨质疏松症是一种全身性骨胳疾病,以骨量减少,骨的微细结构退化,骨强度降低,脆性增加,导致骨折易感性增高为特征的系统性骨胳病变。它是全身功能退行性变的一种表现,男性多见于6 0岁以后,…     

骨代谢相关基因调控通路的研究进展

骨质疏松症是由多种原因引起的骨代谢失衡,导致骨量减少、骨微观结构退变、骨脆性及骨折风险增加的一种复杂疾病,其发病与遗传因素密切相关。文章综述了骨代谢相关基因及其调控通路,主要包括PPAR-γ信号通路、Wnt信号通路和TGF-β信号通路。这些信号通路在骨代谢过程中发挥关键作用,干扰某些靶基因的表达,可以激活或阻断其信号的转导,从而使骨代谢向人们需要的方向倾斜,为骨质疏松症的防治提供新的思路。     

绝经后骨质疏松症的性激素补充疗法

绝经后骨质疏松症,亦称退行性Ⅰ型骨质疏松症.其发病机理主要是由于绝经后雌激素水平骤然下降,促使骨吸收增加,骨矿含量快速丢失,骨折发生率升高.     

老年骨质疏松症预防与康复治疗研究进展

骨质疏松症是以骨量减少,骨组织微结构受损为特征的一种常见疾病,伴有骨脆性增加、骨强度降低,易发生骨折。随着人口老龄化的发展,患有骨质疏松症的人数越来越多,发病率与年龄呈正相关。由骨质疏松症引起的疼痛和骨折等症状严重威胁老年人的健康和生活质量,因此预防和治疗老年骨质疏松症,改善老年人生活质量已为社会广泛关注。本文将从老年骨质疏松症的病因、预防与治疗做一综述。     

原发性骨质疏松症的诊治

原发性骨质疏松症多见于绝经后妇女和老年男性,是一种以骨强度降低致使机体罹患骨折危险性增加为特征的骨骼系统疾病,骨强度包括骨密度和骨质量。目前全世界已有超过2亿人患有骨质疏松症,其发病率已跃居常见病、多发病的第6位。我国60岁以上老年人群中约80%患有不同程度的骨质疏松症。预计2010年将达到1.1亿人,2050年将超过2亿。骨质疏松症已成为全球性的公共卫生问题之一,每年的10月20日被定为"国际骨质疏松日"。     

长春市骨质疏松症的危害和管理对策

作为常见的骨代谢性、全身性疾病,骨质疏松症的主要特征是骨量不足、骨组织微结构被破坏,这种特征会降低骨骼强度,增加骨质脆性,使骨折的发生率大幅上升。该病可发生于各个年龄阶段,但在绝经后女性与老年男性中更为多见,已经演变成危害人类健康的重要病症。人口老龄化的加剧提高了骨质疏松症的发病率,使患病群体不断扩大。但是,大多数人仍未对骨质疏松症有更深刻的认识,经常是症状严重后才去医院诊治,延误病情的同时,也造成了国家和社会的经济负担。为了进一步了解诱发骨质疏松症的危险因素,加强人们对骨质疏松的认识,该研究走访了长春市骨质疏松患病人群,通过问卷调查法观察患病群体的生活习惯,评估各项生活行为对骨质疏松的影响情况,探讨出相关管理措施,以期为长春市当前的骨质疏松防控提供科学依据。     

Osteoporosis in men

With the prolongation of life expectancy, osteoporosis has become an increasing problem in the majority of developed countries worldwide. The paper discusses the frequency, pathogenesis, diagnostic criteria and treatment options for osteoporosis in men. Every third hip fracture occurs in men, and more than 11% of the male population over the age of 50 years suffer the fracture. Diagnostic tests for idiopathic osteoporosis are performed in men under 60 years of age without other potential risk factors of developing the disease. In the majority of cases, their low bone mineral density (BMD) is caused by a low peak bone mass. Secondary osteoporosis occurs in about 30 % of men, and involutionary osteoporosis developed in men over 60 years of age results from their decreased testosterone and IGF-1 levels. The study results showing that BMD levels in both sexes provide similar fracture risk information suggest that the existing diagnostic criteria for female osteoporosis can also be employed in men. It has been proved that biphosphonate and teriparitide therapy significantly increase BMD levels in men. The administration of androgens has been shown to be effective in men with hypogonadism, although their validity for patients with eugonadism has not yet been discussed. An improved knowledge of the bone metabolism and bone remodelling has recently opened the door to an extensive series of molecules that may play a key role in the treatment of male osteoporosis in the future.     

The contribution of bone densitometry to the diagnosis and treatment of osteoporosis

Objective: It has recently been proposed that a specialist osteoporosis service, including bone densitometry, should be made available to those most at risk in the UK population. The aim of this study was to evaluate such a service, and in particular the role of bone densitometry, in terms of its effect on the diagnosis of osteoporosis and clinical management of the disease.Methods: A retrospective data abstraction study was performed to investigate the diagnosis and management of patients referred to the Metabolic Clinic, City Hospital Nottingham, with a potential diagnosis of osteoporosis. Hospital records were available for 117 patients, aged between 45 and 59, who had attended the Clinic in a given time period and undergone bone mineral density measurement.Results: Forty-eight patients (41.0%) had osteoporosis of the lumbar spine. The final diagnosis of osteoporosis after attending the clinic was different from that on referral in a substantial proportion (62.6%) of cases. Only 48.9% of patients with spinal osteoporosis were identified by their referring doctor. The percentage of patients receiving treatment for osteoporosis increased from 34.2% to 72.6% after attending the clinic.Conclusions: Measurement of bone mineral density identifies cases of osteoporosis who would not otherwise be detected and as a consequence contributes to the proportion of patients receiving treatment after referral. The osteoporosis service provided by the Metabolic Clinic including measurement of bone mineral density was thus found to have a considerable impact on the diagnosis and treatment of patients with osteoporosis.     

Nutritional modulators of bone remodeling during aging

Bone mass declines progressively with age in both men and women from the age of approximately 30 y. Increased longevity will inevitability be associated with an increase in the incidence of osteoporosis, its associated complications, and incurred health care costs. Current pharmacologic approaches focus on inhibiting bone resorption in those with osteoporosis but do little to improve bone mass. Increased understanding of the cellular events responsible for normal bone formation has led to multiple pathways that can be targeted to positively influence bone mass. Bone morphogenetic proteins (BMPs) have been shown to stimulate bone formation, and the BMP2 gene was recently linked to osteoporosis. BMP-2 therefore represents one potential molecular target to identify new agents to simulate bone formation. Research is accumulating on the positive effects of dietary sources that stimulate the BMP2 promoter and their effects on bone formation. Flavonoids and statins occur naturally in food products and have been shown to promote bone formation. It may be possible to influence peak bone mass by dietary means and to decrease the risk of osteoporosis in later life. To ease the future burden of osteoporosis, focusing on prevention will be key, and this could include dietary interventions to stimulate bone formation.     

中西医结合治疗老年性骨质疏松症的临床疗效观察

目的：探讨中西医结合治疗老年性骨质疏松症的临床疗效。方法：选取本院2011年1月-2013年1月收治的120例老年性骨质疏松患者作为研究对象,按照随机数字表法将其均分为中西医结合组、中医组和西医组各40例,中西医结合组采取中药补肾活血方加西药钙尔奇D片以及阿法骨化醇片口服治疗,中医组仅采取补肾活血方治疗,西医组仅采取钙尔奇D片以及阿法骨化醇片口服治疗,比较三组患者治疗前后腰部及股骨颈等部位骨密度值变化情况及临床疗效。结果：中西医结合组治疗后腰椎2、腰椎3、腰椎4及股骨颈BMD值均明显高于中医组和西医组,差异均有统计学意义（P〈0.05）;中西医结合组治疗显效率和总有效率均明显高于中医组和西医组,差异均有统计学意义（P〈0.05）。结论：中西医结合治疗老年性骨质疏松症疗效显著,患者骨密度恢复情况良好,无不良反应,临床应用和推广价值较高。     

评价骨质状况及骨质疏松症的超声方法

超声方法评价骨质状况及诊断骨质疏松症是近年来医学超声领域内的研究前沿,并已取得了较大的进展。本文将近年来超声纵波评价松质骨和超声轴向传播技术评价皮质骨以及超声诊断质疏松症的研究进展进行综述,在此基础上提出了当前研究中存在的主要问题及努力的方向。     

骨密度仪在骨质疏松症中的应用进展

骨质疏松是困扰老年人健康生活的危险性疾病,尽早发现和诊断骨质疏松,对减少骨折发生率、提高生活质量有着重要的意义。骨密度仪是临床检测骨密度的常见医疗器械,在骨质疏松临床中有着重要的应用价值,文章对骨密度仪在骨质疏松症中的临床应用进行综述。     

Diagnosis and pharmacologic therapy of osteoporosis

Osteoporosis is a major health care problem of the developed countries. During the last decades, female osteoporosis has been in the center of interest. However, it had to be realized that a significant number of men suffer in this disorder. Beside patient's history and physical examination, bone densitometry, X-ray and biochemical tests are the basis of the diagnosis. Bone densitometry provides accurate information on bone quantity but it does not identify the causes of a potential reduction in bone mineral content. X-ray and laboratory examinations are absolutely essential for differential diagnosis. In the treatment of involutional osteoporosis, a number of effective drugs are available. Their effects on bone tissue have been proven by the methods of evidence-based medicine. In this review, the recent developments in the diagnosis and therapy of osteoporosis have been summarized.     

Up-to-date treatments for osteoporosis

Osteoporosis, despite effective treatment, has a great significance world-wide. It is possible to avoid developing a serious osteoporosis and having bone fracture if we realise the problem at the proper time and take the risk factors into consideration. This article summarises the medications currently used in osteoporosis treatment. The assignment of drugs was by the primary effect on bone metabolism, accordingly anti-catabolic or anabolic drugs. We emphasise the difference between the enlargement of bone mass and the improvement of bone quality and the problem which occurs when we take no notice of this difference. This recognition challenges developing new drugs.     

Osteoporosis and renal dysfunction in a general population exposed to cadmium in China

Osteoporosis is a common metabolic disease characterized by low bone mass and microarchitectural deterioration of bone tissue. Many factors are involved in the occurrence of osteoporosis. Cadmium can cause both osteomalacia and osteoporosis and these effects have long been investigated through various epidemiological or experimental studies. The present study examines a possible relationship between cadmium nephropathy and its effects on the skeleton in populations living in a polluted area in southeast China. Monophoton absorptiometry was used to measure bone mineral density in the population and the Z score (the number of SD from the difference between the measured bone density of the individual and the group mean value for sex- and age-matched controls) was introduced to define osteoporosis (Z score < -2). Osteoporosis caused by cadmium exposure was demonstrated in this study on a general population environmentally exposed to cadmium in China. It was found that there were significant differences in the prevalence of osteoporosis among the different urinary cadmium groups (chi2 = 18.84, P = 0.0008). The linear trend test gave chi2 = 16.281, P = 0.00005. There was a dose-response relationship between cadmium exposure (urinary cadmium) and prevalence of osteoporosis. Of 31 subjects with osteoporosis, 23 subjects were suffering from renal dysfunction. The prevalence of renal dysfunction (74.19%) was significantly higher than that in those without osteoporosis (chi2 = 16.53, P < 0.001). Stratum analysis was performed to further assess the relationship between bone damage and renal impairment caused by cadmium. There was a significant difference between those with and without tubular damage (chi2 = 19.92, P = 0.000) but not in those with and without glomerular damage (chi2 = 0.08, P = 0.114). This showed that glomerular dysfunction plays a smaller role than tubular dysfunction in the causation of bone damage. It was found that the prevalence of osteoporosis increases with increasing values of parameters of tubular damage. Osteoporosis caused by cadmium is thus related to kidney dysfunction and especially to tubular damage and its severity but not to glomerular damage. The present study has thus demonstrated the combined adverse effects (osteoporosis and renal dysfunction) caused by environmental exposure to cadmium for the first time in Asia outside the endemic area in Japan.