Ankrom M A, Shapiro J R
Department of Medicine, Johns Hopkins University, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA.
J Am Geriatr Soc. 1998 Aug;46(8):1025-33. doi: 10.1111/j.1532-5415.1998.tb02763.x.
Paget's disease of bone is important in geriatric populations because it is the second most common bone disorder after osteoporosis. In older people, it may be responsible for chronic back pain and joint pain, skeletal deformities, hearing loss, and cranial nerve compression. Paget's disease can reduce both function and mobility in the older people. In addition to newer tests for assessing the activity of Paget's disease, effective therapy is available in the form of salmon calcitonin for nasal administration and new third generation bisphosphonates. Frequently, treatment can reverse the course of the disease. For these reasons, it is feasible for the physician to adopt an aggressive approach to diagnosis and treatment. The objective should be to relieve pain, improve mobility, and forestall debilitating complications. This review will focus on the manifestations and clinical management of Paget's disease. Two cases are presented that illustrate common management problems in older patients.
骨佩吉特病在老年人群中较为重要，因为它是仅次于骨质疏松症的第二常见骨病。在老年人中，它可能导致慢性背痛和关节疼痛、骨骼畸形、听力丧失以及颅神经受压。佩吉特病会降低老年人的功能和活动能力。除了用于评估佩吉特病活动度的新型检测方法外，还有可通过鼻腔给药的鲑鱼降钙素以及新型第三代双膦酸盐类药物等有效治疗方法。通常，治疗可逆转疾病进程。基于这些原因，医生采取积极的诊断和治疗方法是可行的。目标应是缓解疼痛、改善活动能力并预防使人衰弱的并发症。本综述将聚焦于佩吉特病的表现及临床管理。文中呈现了两个病例，以说明老年患者常见的管理问题。
