Kocián J, Kociánová J
I. interní klinika IPVZ-FTN, Praha 4.
Vnitr Lek. 1998 Mar;44(3):162-5.
Frequent complications of Crohn's disease include disorders of bone mineralization. They are due to a reduced dietary calcium supply in patients with lactose intolerance and a certain degree of malabsorption of calcium as well as vitamin D. The position is made worse by corticoids used in treatment of the basic disease, because they interfere not only with vitamin D conversion into its active (and much more effective) metabolites but also with osteoid formation In the early diagnosis of demineralization a densitometer can be used; markers of bone metabolism are used so far less frequently. As to treatment either blockers of enhanced bone resorption can be used (Ca, vitamin D, bisphosphonates and thyrocalcitonin) or substances stimulating new formation of bone (F, growth factors, in postmenopausal women hormonal substitution treatment) or a combination of preparations from both groups can be used. An irreplaceable part is played also by exercise, depending, of course, on the patient's general condition.
克罗恩病的常见并发症包括骨矿化紊乱。这是由于乳糖不耐受患者饮食中钙供应减少，以及钙和维生素D存在一定程度的吸收不良所致。基础疾病治疗中使用的皮质类固醇会使情况恶化，因为它们不仅会干扰维生素D转化为其活性（且更有效）代谢产物，还会干扰类骨质形成。在脱矿质的早期诊断中可使用骨密度仪；目前骨代谢标志物的使用频率较低。至于治疗，可以使用增强骨吸收的阻滞剂（钙、维生素D、双膦酸盐和降钙素）或刺激新骨形成的物质（氟、生长因子，绝经后女性采用激素替代治疗），或者可以使用两组制剂的组合。当然，根据患者的总体状况，运动也起着不可替代的作用。
