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慢性肝脏疾病中的骨营养不良。

Osteodystrophy in chronic liver diseases.

机构信息

Dipartimento di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy.

出版信息

Intern Emerg Med. 2013 Aug;8(5):377-88. doi: 10.1007/s11739-012-0753-5. Epub 2012 Jan 13.

Abstract

Osteoporosis and osteomalacia are, to date, among the most common metabolic diseases in the world. Lately, an association between metabolic bone diseases and chronic liver disease has been increasingly reported, inducing many authors to create a new nosographic entity known as 'hepatic osteodystrophy.' The importance of such a condition is further increased by the morbidity of these two diseases, which greatly reduce the quality of life because of frequent fractures, especially vertebral and femoral neck ones. For this reason, early identification of high-risk patients should be routinely performed by measuring bone mass density. The explanation for the association between bone diseases and chronic liver disease is still uncertain, and involves many factors: from hypogonadism to use of corticosteroid drugs, from genetic factors to interferon therapy. To date, few studies have been conducted, and all with a small number of patients to establish definitive conclusions about the possible treatment, but some evidence is beginning to emerge about the safety and efficacy of bisphosphonates.

摘要

骨质疏松症和佝偻病是迄今为止世界上最常见的代谢性疾病之一。最近,代谢性骨病与慢性肝病之间的关联越来越多地被报道,促使许多作者创造了一种新的疾病实体,称为“肝性骨营养不良症”。由于这两种疾病的发病率很高,导致频繁发生骨折,尤其是椎体和股骨颈骨折,因此这种情况的重要性进一步增加。出于这个原因,应该通过测量骨密度来常规识别高危患者。骨病与慢性肝病之间关联的原因尚不确定,涉及许多因素:从性腺功能减退到使用皮质类固醇药物,从遗传因素到干扰素治疗。到目前为止,已经进行了很少的研究,而且所有研究的患者数量都很少,无法就可能的治疗方法得出明确的结论,但关于双膦酸盐的安全性和有效性开始出现一些证据。

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