绝经后骨质疏松的动物模型

绝经后骨质疏松的动物模型陈槐卿李良郑虎老年性骨质疏松症是中老年人的常见病，严重威胁着中老年人的健康，使他们的生活质量下降。随着我国经济的发展，人民生活水平不断提高，我国居民平均寿命延长，到２１世纪，我国将进入老龄化社会，老年性骨质疏松，尤其是妇女绝经...     

葛根素对绝经后骨质疏松大鼠不同部位骨骼的抗骨质疏松作用差异的研究

目的本文拟通过动物实验研究葛根素对大鼠骨密度的影响,探讨葛根素对不同部位骨骼抗骨质疏松作用的差异。 方法对24只雌性SD大鼠行双侧卵巢切除术,构建大鼠绝经后骨质疏松模型。采用葛根素处理大鼠后,分别于第2、4、8、12周采用双能X射线吸收法（DXA）检测其各部位骨骼骨密度随时间发生的变化,并对比不同部位骨骼骨密度、骨矿含量的差异,同时通过组织切片观察葛根素对骨组织微结构的影响。 结果葛根素应用后的第8周疗效最为显著,经葛根素处理后股骨远端、腰椎等松质骨的骨密度、骨矿含量显著提高,且骨小梁更粗、数量更多,而股骨中段等皮质骨的骨密度、骨矿含量变化则不大。 结论葛根素对绝经后骨质疏松大鼠松质骨的抗骨质疏松作用优于皮质骨。     

α-骨化醇治疗绝经后骨质疏松患者的疗效观察

目的：观察α-骨化醇治疗对绝经后骨质疏松症患者的临床疗效。方法120例绝经后骨质疏松患者随机分为α-骨化醇治疗组（治疗组）及安慰剂对照组（对照组）,治疗1年,分别在治疗前、后检测患者骨密度。结果试验后两组患者骨密度均降低,对照组试验后骨密度显著低于试验前（P＜0．05）,但试验组骨密度显著高于对照（P＜0．05）。结论α-骨化醇可有效治疗绝经后骨质疏松。     

鲑降钙素治疗绝经后骨质疏松200 例分析

目的评价鲑降钙素治疗绝经后妇女骨质疏松症的疗效以及用药。方法采用随机对照研究,300名患绝经后骨质疏松症妇女被随机分为三组,鲑降钙素每日100μ组,鲑降钙素每日50μ组,对照组。于治疗3个月、6个月、1年后3次复查骨密度。结果每天应用100μ鲑降钙素疗效明显优于每天50μ鲑降钙素组(P<0.05),两治疗组疗效明显优于对照组(P<0.05)。结论鲑降钙素治疗绝经后骨质疏松症有明确疗效,应足量、足疗程应用。     

骨质疏松预防与自我管理课程对绝经后女性骨质疏松认知及健康行为的影响

目的评价骨质疏松预防与自我管理课程(osteoporosis prevention and self-management course,OPSMC)对绝经后女性骨质疏松认知及健康行为的影响。方法将2011年7月-2012年7月在沈阳军区总医院就诊的267名绝经后妇女随机分为干预组133例和对照组134例。干预组采用OPSMC规定课程,对照组同步实施与骨质疏松无关的健康宣教。干预前及3个月后分别采用骨质疏松症知识问卷(OKT)、骨质疏松症自我效能量表(OSES)和自设的骨质疏松健康行为问卷对两组受试者进行评价。结果 2组受试者OKT和OSES评分在不同时间点差异有统计学意义(P0.001),不同干预方式对OKT和OSES评分影响不同(P0.001),干预与时间点之间有交互作用(P0.001)。在3个月时,干预组更加重视补充钙剂(19.5%vs1.8%,P0.01)、维生素D(14.4%vs 0.9%,P0.01)、含钙食物摄入(15.3%vs 2.7%,P0.01)、每周锻炼次数(9.3%vs0.9%,P0.01)及强度(27.9%vs 8.8%,P0.01)。结论 OPSMC是一种有效的骨质疏松健康干预措施,短期内可以提高绝经后女性骨质疏松认知水平,促进健康行为。     

绝经后妇女骨质疏松性椎体骨折与腰椎骨密度的关系

目的探讨绝经后妇女骨质疏松性椎体骨折与腰椎骨密度的关系。方法选择骨质疏松性椎体骨折的绝经后妇女23例为骨折组,无椎体骨折的25例绝经后骨质疏松妇女为对照组。两组的年龄、绝经年限、身高、体重、体重指数差异无显著性,均行胸腰椎正侧位X线摄片。用双能X线吸收仪（DXA）测量的腰椎（L2-4）前后位骨密度（BMD）、骨矿含量（BMC）和T值。结果骨折组BMD、BMC和T值均低于对照组（P〈0.01）。结论腰椎BMD降低与绝经后妇女的骨质疏松性椎体骨折相关。绝经后骨质疏松妇女应重视BMD变化,预防椎体骨折的发生。     

绝经后女性骨质疏松性椎体骨折与腰椎体骨密度的相关性

随着我国步入老龄化社会,骨质疏松症的患病率明显升高。骨质疏松症最严重的危害来自骨质疏松性骨折,绝经后女性尤其多见。由于脊柱独特的解剖学和生物力学特点,骨质疏松患者更易发生椎体骨折。骨密度测量是诊断骨质疏松的金标准。本文通过回顾近年来相关文献,探讨腰椎体骨密度检测对绝经后女性骨质疏松性椎体骨折的意义,发现:绝经后骨质疏松性椎体骨折患者的BMD水平比绝经后骨质疏松症但无脊椎骨折者明显减少;绝经后骨质疏松症患者的BMD水平越低,其发生椎体骨折的风险越高;有椎体骨折史的绝经后骨质疏松症患者的BMD水平与发生再次椎体骨折的风险呈负相关。药物干预通常可明显提高绝经后骨质疏松症患者的BMD水平,同时还可减少椎体骨折的发生。尚存在一些不足:腰椎骨密度可能出现假性增高;需进一步探讨预测骨质疏松性椎体骨折的骨密度阈值;药物干预的研究中BMD水平与椎体骨折发生的相关性并没有得到深入研究;缺少大规模的绝经后骨质疏松性椎体骨折的流行病学,现有研究也大都存在病例收集方法不规范、样本量小、年龄分布存在差异等不足。对绝经后骨质疏松性椎体骨折的深入研究需要多学科共同协作。     

绝经后骨质疏松症与牙周炎

宿主因素对牙周炎的临床及病理变化发挥着重要的作用。作为危及中老年妇女健康的一种常见病和多发病,绝经后骨质疏松症与牙周炎间的相互关系逐渐引起国内外学者的重视。本文就绝经后骨质疏松症及其治疗药物与牙周炎的关系做一综述。     

青娥丸治疗绝经后骨质疏松症的作用机制

目的　基于文献研究并借助网络药理学探索分析青娥丸治疗绝经后骨质疏松症(ｐｏｓｔｍｅｎｏｐａｕｓａｌ ｏｓｔｅｏｐｏｒｏｓｉｓ?ＰＭＯＰ)的作用机制? 方法　通过查阅文献总结青娥丸在治疗ＰＭＯＰ 中的临床应用、药理机制和活性成分?依托传统网络药理学基础上联合高质量蛋白组学数据库ＨＩＮＴ 对ＰＭＯＰ 疾病靶标进行拓展?分析探索青娥丸治疗ＰＭＯＰ 的关键途径并运用分子对接技术对关键蛋白进行验证?从而推测其潜在机制? 结果　青娥丸中有效成分３７ 个?有效成分作用靶点２１８ 个? 在ＤｉｓＧｅＮＥＴ 数据库中筛选并通过ＨＩＮＴ 拓展得到青娥丸治疗ＰＭＯＰ 的关键靶点７９ 个? 其治疗ＰＭＯＰ 可能主要涉及ＴＮＦ、破骨细胞分化、雌激素等信号通路? 分子对接显示青娥丸中槲皮素、山奈酚、β￣谷甾醇等成分对关键靶点ＪＵＮ、ＶＥＧＦＡ、ＩＬ６、ＡＣＴＢ 等具有良好的结合能力? 结论　通过总结发现青娥丸临床疗效突出?安全有效?网络药理研究发现青娥丸具有通过多途径、多靶点治疗ＰＭＯＰ的作用?为这一经典方剂的二次开发以及新药的研发具有重要意义?     

细胞因子在绝经后骨质疏松症发病机制中的作用

雌激素、免疫细胞因子及骨代谢三者相互作用,绝经后骨质疏松症主要与雌激素缺乏导致细胞因子激活破骨细胞的活性密切相关。雌激素缺乏导致巨噬细胞和T细胞分泌IL-1和TNFα,抑制调节性T细胞增殖和成熟,促进NFκB、IL-15和IL-17的产生,从而诱导破骨细胞发展;抑制成骨细胞和骨系细胞产生OPG,促进RANK-RANKL相互作用,导致破骨细胞活性增强;抑制成骨细胞和骨细胞的TGFβ,减少破骨细胞凋亡。     

Effect of cyclical therapy with phosphorus and etidronate on axial bone mineral density in postmenopausal osteoporotic women

Forty seven women with postmenopausal osteoporosis and at least one but no more than four vertebral compression fractures received sequential and cyclical therapy with phosphorus and etidronate (p/etid). During the same 2-year period of observation, three other groups of patients received either sodium fluoride (n=12), estrogen replacement therapy (n=12), or vitamin D and calcium (Ca⁺⁺) alone (n=15).Axial bone mineral density (BMD) was measured by means of dual-photon absorptiometry. Lateral thoracic and lumbar spine radiographs were taken to assess fractures. Bone mineral density increased from baseline during p/etid therapy: Mean 15.7±1.6% (SD) (P<0.001). During the same time, the patients in the sodium fluoride group showed a comparable increase in their BMD from baseline: mean 15.7±1.1% (P<0.001). During the first year of therapy, patients in the estrogen replacement group had an increase in their BMD from baseline: mean: 4.6%±1.1% (P<0.05). No change in BMD was seen in the control group that received vitamin D and Ca⁺⁺ alone.No patient who received p/etid, sodium fluoride, or estrogen replacement therapy had any new vertebral compression fractures or height loss, whereas in the control group that received vitamin D and Ca⁺⁺ alone 6 out of 15 had height loss and at least one new vertebral fracture (P<0.01).p/etid therapy increases BMD in women with postmenopausal osteoporosis comparable to sodium fluoride but without side effects or toxicity and stabilizes vertebral compression fractures.     

绝经后激素替代治疗的妇女发生骨质疏松时某些细胞因子水平的改变

目的：旨在探讨健康和骨质疏松的激素替代治疗的绝经后妇女中全血细胞产生某些细胞因子水平的不同，论证这些细胞因子与绝经后骨质疏松的关系。对象：43名白人绝经后立即激素替代治疗的妇女，分为骨质疏松组（n＝12）和正常对照组（n＝31）。取全血，一半不作处理，作为对照组，一半加入多克隆的刺激剂，作为刺激组，培养4h或72h，使用ELISA法测定细胞因子IL－1β，IL-6，TNFα，INF-γ，GM-CSF和ILF。结果：在骨质疏松的绝经后激素替代治疗妇女中，较之无骨质疏松的同组人群，细胞因子IL－6水平升高，LFN－γ，LIF水平降低，结论：虽然同样绝经后即开始激素替代治疗，一些妇女依旧发生骨质疏松，本研究发现IL－6在这部分病人中可能是一种致病因素，而TNF－γ，LIF是一种保护因素。     

Calcium absorption in normal and osteoporotic postmenopausal women

Summary Hourly fractional absorption of radiocalcium (alpha), serum calcitriol, and a number of other variables were measured in 152 normal and 148 osteoporotic postmenopausal women. Alpha, body weight, and serum albumin were all significantly lower in the osteoporotic than in the normal women, and plasma alkaline phosphatase, fasting urinary calcium, sodium, and hydroxyproline were all significantly higher in the osteoporotic than in the normal group. The most significant determinant of alpha in each group was the serum calcitriol concentration, but calcium absorption relative to serum calcitriol was significantly lower in the osteoporotic than in the normal women. The serum calcitriol level was slightly but not significantly lower in the osteoporotic than in the normal group and accounted for only 20% of the difference in alpha between them. The implied “resistance” to calcitriol in the osteoporotic group was significantly related to serum albumin and body weight but independent of age. Urinary hydroxyproline was an inverse function of alpha and a positive function of fasting urinary calcium in the osteoporotic group.     

Effect of ipriflavone in combination with calcium supplements on bone metabolism in elderly osteoporotic women

Ipriflavone and calcium supplements are used in the treatment of osteoporosis. However, the effect of ipriflavone in combination with high-dose calcium supplements (1 g/day) on bone metabolism in elderly osteoporotic women is still a matter of controversy. Enrolled in this study were 22 women over 70 years of age diagnosed as having involutional osteoporosis. The patients were randomly assigned to treatment with either ipriflavone plus calcium or with calcium supplements only for 6 months. Biochemical markers of bone metabolism and bone mass of the hand were determined at baseline and at 6 months. Serum parathyroid hormone, serum osteocalcin, serum alkaline phosphatase, and the urinary hydroxyproline/creatinine ratio decreased in both groups. These decreases were greater in the ipriflavone plus calcium supplement group than in the calcium supplement only group. Serum calcitonin increased in the ipriflavone plus calcium supplement group. Metacarpal index and metacarpal bone mineral density did not change in either group. These findings suggest that treatment with ipriflavone plus calcium supplements may inhibit bone resorption and modulate bone turnover in elderly osteoporotic women and may be more effective than calcium supplements alone.     

地舒单抗对绝经后骨质疏松性股骨颈骨折全髋关节置换术后股骨近端假体周围骨密度的影响

目的:研究地舒单抗对绝经后骨质疏松性股骨颈骨折患者全髋关节置换术后(total hip arthroplasty,THA)股骨近端假体周围骨密度的影响。方法:选取2020年10月至2021年10月绝经后女性骨质疏松性股骨颈骨折行THA术后54例,治疗组25例接受地舒单抗治疗,年龄(74.3±6.2)岁;对照组29例未接受地舒单抗治疗,年龄(75.2±4.8)岁。术后1周及3、6及12个月各个时间点,通过双能X线骨密度仪(DEXA型)测定股骨近端假体周围骨密度,并在不同时间点测量骨转换各项指标。结果:术后3、6及12个月对照组的抗酒石酸酸性磷酸酶(tartrate resistant acid phosphatase,TRACP-5b)高于治疗组(P<0.05);对照组术后12个月骨特异性碱性磷酸酶(bone-specific alkaline phosphatase,BALP)高于治疗组(P<0.05)。两组患者Gruen 1、7区的骨密度在术后3、6及12个月较术后1周(基线)均下降(P<0.05);对照组Gruen 7区术后各时间点比较,差异有统计学意义(P<0.05);治疗组各时间点比较,差异无统计学意义(P>0.05)。两组术后3个月Gruen 1、7区比较,差异无统计学意义(P>0.05);术后6个月Gruen 1、7区和术后12个月Gruen 1、7区,治疗组骨密度均明显高于对照组(P<0.05)。两组术后3个月Gruen 1、7区骨密度下降百分比比较,差异无统计学意义(P>0.05)。对照组术后6个月Gruen 1、7区,术后12个月Gruen 1、7区骨密度下降百分比明显高于治疗组(P<0.05)。提示在使用地舒单抗6个月后,即可降低骨密度丢失幅度,并且该效应可达至术后12个月。结论:绝经后骨质疏松性股骨颈骨折患者在THA术后,使用地舒单抗可减少股骨近端假体周围骨密度丢失,有效抑制骨吸收。     

中年男性雄激素部分缺乏症的睾酮补充治疗

目的　观察睾酮补充治疗对中年男子雄激素部分缺乏症的疗效。　方法　2001年12月至2004年4月男科门诊经雄激素部分缺乏问卷评分、血清总睾酮(TT)和游离睾酮(fT)测定筛选出雄激素部分缺乏症患者179例,平均年龄41. 8岁,无器质性疾病和病原体感染。136例作为治疗组予口服十一酸睾酮3个月, 80mg/次,每日早餐、晚餐时各1次, 43例作为对照组未予特殊治疗。观察比较治疗前后雄激素部分缺乏评分和性激素的变化。　结果　治疗组治疗后1、3个月雄激素部分缺乏评分总分和构成评分与治疗前比较明显改善(P均<0. 01 )。治疗前患者TT、fT、雌二醇分别为(11. 9±0. 9)nmol/L、(40. 6±11. 8)pmol/L、( 128. 1±40. 1 )pmol/L。治疗后3个月分别为( 19. 1±1. 2)nmol/L, (75. 2±17. 0)pmol/L, (100. 6±27. 5)pmol/L,差异均有统计学意义(P均<0. 01 )。对照组雄激素部分缺乏评分总分和构成评分及性激素水平无显著变化。　结论　中年男子雄激素部分缺乏症在临床上客观存在,睾酮补充治疗对中年雄激素部分缺乏症安全、有效。     

绝经期骨质疏松雌激素替代治疗临床研究

１９９５￣１９９８三年中,对绝经期骨质疏松（ＭＯＰ）１１１例进行为期２年的前瞻性雌激素替代治疗（ＨＲＴ）研究,其中５６人应用利维爱（Ｌｉｖｉａｌ）为研究组,５５人应用尼尔雌醇为对照组,经过２年随诊,终点结论是ＨＲＴ对缓解更年期症状,提高患生活质量,增加骨密度（ＢＭＤ）都有效果,但研究组明显优于对照组,具有统计学意义。ＨＲＴ的副作用为血：治疗组５．３５％,对照组１０．９％,乳房胀痛：治疗组７．１４     

The effect of milk supplementation on bone mineral density in postmenopausal Chinese women in Malaysia

Dietary studies often report low calcium intake amongst post-menopausal Malaysian women and calcium deficiency has been implicated as part of the etiology of age-related bone loss leading to osteoporosis. Therefore, the objective of this study was to examine the effectiveness of high calcium skimmed milk (Anlene Gold, New Zealand Milk, Wellington, New Zealand) to reduce bone loss in Chinese postmenopausal women. Two hundred subjects aged 55–65 years and who were more than 5 years postmenopausal were randomized to a milk group and control group. The milk group consumed 50 g of high calcium skimmed milk powder daily, which contained 1200 mg calcium (taken as two glasses of milk a day). The control group continued with their usual diet. Using repeated measures ANCOVA, the milk supplement was found to significantly reduce the percentage of bone loss at the total body compared to the control group at 24 months (control –1.04%, milk –0.13%; P<0.001). At the lumbar spine, the percentage of bone loss in the control group was significantly higher (–0.90%) when compared to the milk (–0.13%) supplemented group at 24 months (P<0.05). Similarly, milk supplementation reduced the percentage of bone loss at the femoral neck (control –1.21%, milk 0.51%) (P<0.01) and total hip (control –2.17%, milk –0.50%) (P<0.01). The supplemented group did not experience any significant weight gain over the 24 months. The serum 25-hydroxy vitamin D level improved significantly (P<0.01) from 69.1±16.1 nmol/l at baseline to 86.4±22.0 nmol/l at 24 months in the milk group. In conclusion, ingestion of high calcium skimmed milk was effective in reducing the rate of bone loss at clinically important lumbar spine and hip sites in postmenopausal Chinese women in Malaysia. Supplementing with milk had additional benefits of improving the serum 25-hydroxy vitamin D status of the subjects.     

DASRR程序治疗131例绝经后骨质疏松症妇女的5年临床研究

目的：观察DASRR程序治疗方案长期治疗绝经后骨质疏松症的疗效。方法：131例绝经后骨质疏松症患，用DASRR方案按程序先用二膦酸盐2周（羟乙膦酸钠）或4周（阿仑膦酸钠），以抑制骨吸收活动；接着用氟化物1个月，以刺激骨形成；再用活性维生素D3及钙剂1个月以加强成骨，停药1个月自发诱导下一个骨代谢周期，再按上述程序重复周期，结果：通过2－12个重复程序的治疗，骨密度（BMD）多呈明显上升趋势，其中腰椎增加13．41％（P＜0．05），双髋部平均BMD增加9．36％（P＜0．05）；骨折率逐年降低，结论：DASRR程序长期治疗绝经后骨质疏公症能更显增加腰椎和髋部BMD，降低新骨折率。