Uebelhart B, Rizzoli R
Département de médecine interne, Hôpital cantonal, Genève.
Rev Med Suisse Romande. 2000 Oct;120(10):787-91.
Osteoporosis and fractures are frequent and severe consequences of long-term treatment with glucocorticoids. Trabecular bone is mainly affected with a decrease of bone formation and an increase of bone resorption. Prevention and treatment of corticosteroid-induced osteoporosis is based upon general measures such as calcium and vitamin D supplementation, adequate+ protein intake, regular physical exercise, hormonal replacement therapy and upon specific means like therapies used in primary osteoporosis. Bisphosphonates which are potent bone resorption inhibitors have been shown to increase bone mineral density and to decrease fracture rate. Therefore they appear as first choice in the prevention as well as in the treatment of corticosteroid-induced osteoporosis.
骨质疏松症和骨折是长期使用糖皮质激素治疗的常见且严重的后果。小梁骨主要受到影响,骨形成减少而骨吸收增加。糖皮质激素诱导的骨质疏松症的预防和治疗基于一般措施,如补充钙和维生素D、充足的蛋白质摄入、定期体育锻炼、激素替代疗法,以及基于用于原发性骨质疏松症的特定方法。双膦酸盐作为强效骨吸收抑制剂,已被证明可增加骨矿物质密度并降低骨折率。因此,它们似乎是预防和治疗糖皮质激素诱导的骨质疏松症的首选药物。