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不同生命阶段及状况下骨质疏松症的预防

[Prevention of osteoporosis in different life stages and conditions].

作者信息

Ohta Hiroaki

机构信息

Department of Clinical Medical Research Center, International University of Health and Welfare/Women's Medical Center of Sanno Medical Center, Japan.

出版信息

Clin Calcium. 2014 Mar;24(3):391-400.

Abstract

While prevention forms part of the armamentarium for osteoporosis which is no less important than treatment, there is as yet a paucity of evidence that provides the rationale for prevention compared to that for treatment in osteoporosis. While preventive measures against osteoporosis vary depending on the life stage of the patient being targeted (i.e., young, perimenopausal or elderly) , prevention is being addressed in this article from a different perspective with a focus on the following three areas : prevention of onset of osteoporosis, prevention of osteoporotic fracture, and prevention of falls. The biggest challenge in preventing the onset of osteoporosis has to do with how best to alert the patient to the risk of osteoporosis which remains nearly asymptomatic, then to encourage her to seek medical consultation, and finally to prevent osteoporosis from happening in the patient. Again, while the importance of preventing primary osteoporotic fracture is beginning to be widely recognized, how to keep a chain reaction of fracture events from happening in osteoporotic patients remains a major challenge to be addressed. Lastly, as fracture events go hand in hand with falls, how to minimize the impact of falls in such a way that they do not lead to fractures remains yet another challenge calling for attention.

摘要

虽然预防是骨质疏松症防治手段的一部分,其重要性不亚于治疗,但与骨质疏松症治疗的依据相比,目前仍缺乏为预防提供理论基础的证据。虽然针对骨质疏松症的预防措施因目标患者的生命阶段(即年轻、围绝经期或老年)而异,但本文将从不同角度探讨预防问题,重点关注以下三个方面:预防骨质疏松症的发生、预防骨质疏松性骨折以及预防跌倒。预防骨质疏松症发生的最大挑战在于如何以最佳方式提醒患者注意几乎没有症状的骨质疏松症风险,然后鼓励她寻求医疗咨询,最后防止患者发生骨质疏松症。同样,虽然预防原发性骨质疏松性骨折的重要性开始得到广泛认可,但如何防止骨质疏松症患者发生骨折事件的连锁反应仍然是一个有待解决的重大挑战。最后,由于骨折事件与跌倒密切相关,如何以不导致骨折的方式将跌倒的影响降至最低仍然是另一个需要关注的挑战。

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