80岁以上高龄老年骨质疏松症的规范诊治和注意事项

被引：37

作者：

边平达

陈锦平

机构：

[1] 浙江省人民医院骨质疏松诊疗中心

来源：

中国骨质疏松杂志 | 2015年 / 21卷 / 06期

关键词：

骨质疏松症; 诊治; 高龄; 骨密度; 骨转换标志物;

D O I：

暂无

中图分类号：

R580 [];

学科分类号：

摘要：

骨质疏松症(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。近年来,随着人口老龄化社会的到来,高龄老年OP患者越来越多。高龄老年OP的发生与高龄老人体内性激素(包括雌激素和雄激素)水平下降、营养物质摄入减少、活动量下降、某些疾病等因素有关。高龄老年OP患者不仅脆性骨折的发生率高,而且骨折后容易致残、致死。高龄老年OP诊治的基本内容包括普查和健康教育、选择合适的抗OP药物、及时调整治疗方案等。骨转换标志物(BTMs)的检测是高龄老年OP患者选择抗OP药物的重要依据,一般来说,对BTMs较高的高龄骨量减少和OP患者,应选择使用抗骨吸收药物,如双膦酸盐类和选择性雌激素受体调节剂等,而对BTMs较低的高龄OP患者,应选择使用促骨形成药物(如重组人甲状旁腺激素1-34)。要注意根据高龄老年OP患者骨密度和BTMs的变化,及时调整治疗方案,避免长期使用双膦酸盐类药物。

引用

页码：757 / 760+768 +768

页数：5

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