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药物性骨质疏松症

Medication-induced osteoporosis.

作者信息

Weng Meng-Yi, Lane Nancy E

机构信息

Department of Medicine, University of California at Davis, Sacramento, CA 95817, USA.

出版信息

Curr Osteoporos Rep. 2007 Dec;5(4):139-45. doi: 10.1007/s11914-007-0008-y.

Abstract

Osteoporosis, a condition of low bone mass and microarchitectural deterioration, results in fractures with minimal trauma. Secondary osteoporosis is defined as bone loss resulting from either specific clinical disorders or medications. Some medications that can induce osteoporosis are discussed. Specifically, this article reviews the pathogenesis of glucocorticoid-induced bone loss and demonstrates the means to successfully manage the condition with a combination of calcium and vitamin D supplementation and, depending on the severity of the bone loss, bisphosphonates or parathyroid hormone. In addition, the pathophysiology of bone loss from aromatase inhibitors in women, gonadotropin-releasing hormone agonists in men, anticonvulsant medications, and proton pump inhibitors is outlined. Finally, this review offers suggestions on evaluation and management of bone health in individuals treated with these medications for prolonged times.

摘要

骨质疏松症是一种骨量低和微结构破坏的病症,会导致在极少创伤的情况下发生骨折。继发性骨质疏松症被定义为由特定临床疾病或药物引起的骨质流失。本文讨论了一些可诱发骨质疏松症的药物。具体而言,本文回顾了糖皮质激素诱导的骨质流失的发病机制,并展示了通过补充钙和维生素D,以及根据骨质流失的严重程度联合使用双膦酸盐或甲状旁腺激素来成功控制该病的方法。此外,还概述了女性使用芳香化酶抑制剂、男性使用促性腺激素释放激素激动剂、抗惊厥药物和质子泵抑制剂导致骨质流失的病理生理学。最后,本综述针对长期使用这些药物治疗的个体的骨骼健康评估和管理提出了建议。

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