从药物假期谈双膦酸盐在老年骨质疏松症患者中的合理应用

发布时间：2018-01-11 02:08

本文关键词：从药物假期谈双膦酸盐在老年骨质疏松症患者中的合理应用　出处：《中国骨质疏松杂志》2016年12期 　论文类型：期刊论文

【摘要】：骨质疏松症(osteoporosis,OP)是一种以骨量低下、骨微结构破坏,导致骨脆性增加、易发生骨折为特征的全身性疾病。双膦酸盐是目前最常用的抗OP药物,它能有效降低OP患者椎体、非椎体和髋部骨折的风险。但是长期使用双膦酸盐类药物会出现疗效下降,并诱发不典型骨折和下颌骨坏死等严重并发症。目前一般建议连续使用双膦酸盐药物3~5年后,就进入药物假期。在药物假期期间,应注意定期检测骨密度(bone mineral density,BMD)和骨转换标志物(bone turnover markers,BTMs),并根据两者的变化,来决定下一步治疗方案。一般来说,如BTMs水平较低、BMD稳定,则药物假期继续;如BTMs水平增高、BMD下降,应重新接受抗骨吸收治疗;如BTMs水平较低、BMD下降,则应考虑改用特立帕肽成骨治疗。
[Abstract]:Osteoporosis (Osteoporosissis OPO) is a kind of low bone mass, the destruction of bone microstructure, resulting in the increase of bone brittleness. Bisphosphonates are the most commonly used anti-op drugs, which can effectively reduce the vertebral body of patients with op. The risk of non-vertebral and hip fractures. But long-term use of bisphosphonates can reduce the efficacy. Severe complications such as atypical fractures and osteonecrosis of the mandible were induced. At present, it is generally recommended to use bisphosphonates 3 ~ 5 years later and then enter the drug holiday. The bone mineral density (BMD) and bone turnover markers (BMD) were detected regularly. BTMsN, and according to the changes in both, to determine the next treatment program. Generally speaking, if the BTMs level is lower, BMD is stable, then the drug holiday continues; If the level of BTMs increased or decreased, anti-bone resorption therapy should be taken again. If the BTMs level is lower, we should consider using maverapeptide osteogenesis therapy.
【作者单位】：浙江省人民医院骨质疏松诊疗中心;浙江省人民医院药学部;
【基金】：浙江省医药卫生平台重点资助项目(2016ZDA002) 浙江省人民医院优秀青年人员科研启动基金(zry2015C002)
【分类号】：R580
【正文快照】： 骨质疏松症(osteoporpsis,OP)是一种以骨量低下、骨微结构破坏,导致骨脆性增加、易发生骨折为特征的全身性疾病,它可发生于不同性别和年龄,但多见于绝经后女性和老年男性[1]。有研究表明,中国大陆地区40岁以上OP发病率约为20%,估计共有1.12亿患者人群[2]。OP的严重后果是发生

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