预防糖皮质激素所致骨质疏松的循证医学证据

被引：4

作者：

曹立

吴红梅

张新军

李峻

机构：

[1] 四川大学华西医院老年病科

[2] 四川大学华西医院老年病科四川成都

来源：

中国实用内科杂志 | 2006年 / 02期

关键词：

糖皮质激素; 继发性骨质疏松; 循证预防;

D O I：

暂无

中图分类号：

R595.3 [药源性疾病];

学科分类号：

1002 ; 100201 ;

摘要：

目的为获得预防糖皮质激素所致骨质疏松的最有效方法,用循证医学的方法检索和评价目前可获得的最佳证据。方法计算机检索ACPJournalClub(1991-012005-09)、美国AHRQ证据报告、Co-chrane图书馆(2005年第3期)和MEDLINE(1990-012005-09),查找预防糖皮质激素所致骨质疏松的系统评价、临床随机对照试验、卫生经济学评价等,并对所获证据质量进行评价。结果目前最佳的临床证据表明,预防性使用维生素D或其活性类似物加钙、双磷酸盐等能确切提高糖皮质激素所致骨质疏松者的骨密度。现有证据显示各类药物对骨折的减少作用没有统计学意义。结论维生素D或其活性类似物加钙是长期服用糖皮质激素患者预防骨质疏松的首选药物,双磷酸盐也是可选药物。

引用

页码：142 / 145

页数：4

共 13 条

[1]

Use of oral corticosteroids in the community and the prevention of secondary osteoporosis:a cross sectional study. Walsh LJ,WongCA,Pringle M,et al. British Medical Journal . 1996

[2]

Vertebral fractures i steroid dependent asthma and involutional osteoporosis:a com parative study. Luengo M,Picado C,Del RL,et al. Thorax . 1991

[3]

Bisphosphonates for ster-oid-induced osteoporosis. Homik J,Cranney A,Shea B,et al. Systematic Rev,The Cochrane Library . 2005

[4] Effect of sodium fluoride on the prevention of corticosteroid-induced osteoporosis [J].

Lems, WF ;

Jacobs, WG ;

Bijlsma, JWJ ;

Croone, A ;

Haanen, HCM ;

Houben, HHML ;

Gerrits, MI ;

van Rijn, HJM .

OSTEOPOROSIS INTERNATIONAL, 1997, 7 (06) :575-582

[5]

The Epidemiology of Corticosteroid-Induced Osteoporosis: a Meta-analysis[J] . T. P. van Staa,T. P. van Staa,T. P. van Staa,H. G. M. Leufkens,C. Cooper. &nbspOsteoporosis International . 2002 (10)

[6]

Calcium and vitamin D for corticosteriod-induced osteoporosis. Homik J,Cranney A,Shea BJ,et al. The Cochrane Li-brary . 2005

[7]

The role of vitamin D in corticosteroid-induced osteoporosis:a meta-analytic approach. Amin S,LaValley MP,Simms RW,et al. Arthritis and Rheumatism . 1999

[8]

Epidemiology and clinica features of osteoporosis in young individuals. S Khosla,EG Lufkin,SF Hodgson. Bone .

[9]

Vertebral fractures in patients with rheumatoid arthritis treated with corticosteroids. Lems WF,Jahangier ZN,Jacobs JW. Clin Ex-perim Rheumatol . 1995

[10]

Calcitonin for preven-ting and treating corticosteroid-induced osteoporosis. Cranney A,Adachi JD,Homik J,et al. Sys-tematic Rev,The Cochrane Library . 2005

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