Sweet Mary Gayle, Sweet Jon M, Jeremiah Michael P, Galazka Sim S
Carilion Clinic Family Medicine Residency Program, Roanoke, Virginia 24017, USA.
Am Fam Physician. 2009 Feb 1;79(3):193-200.
Osteoporosis affects approximately 8 million women and 2 million men in the United States. The associated fractures are a common and preventable cause of morbidity and mortality in up to 50 percent of older women. The U.S. Preventive Services Task Force recommends using dual energy x-ray absorptiometry to screen all women 65 years and older and women 60 to 64 years of age who have increased fracture risk. Some organizations recommend considering screening in all men 70 years and older. For persons with osteoporosis diagnosed by dual energy x-ray absorptiometry or previous fragility fracture, effective first-line treatment consists of fall prevention, adequate intake of calcium (at least 1,200 mg per day) and vitamin D (at least 700 to 800 IU per day), and treatment with a bisphosphonate. Raloxifene, calcitonin, teriparatide, or hormone therapy maybe considered for certain subsets of patients.
在美国，约800万女性和200万男性患有骨质疏松症。相关骨折是高达50%老年女性发病和死亡的常见且可预防的原因。美国预防服务工作组建议使用双能X线吸收法对所有65岁及以上女性以及骨折风险增加的60至64岁女性进行筛查。一些组织建议考虑对所有70岁及以上男性进行筛查。对于通过双能X线吸收法诊断为骨质疏松症或既往有脆性骨折的患者，有效的一线治疗包括预防跌倒、充足摄入钙（每天至少1200毫克）和维生素D（每天至少700至800国际单位），以及使用双膦酸盐进行治疗。对于某些特定患者亚组，可考虑使用雷洛昔芬、降钙素、特立帕肽或激素疗法。
