骨质疏松症的诊断与治疗

<正>据调查数据显示,我国已成为世界上拥有骨质疏松症患者最多的国家,约9 000万,占总人口的7%,并且呈上升趋势[1]。骨质疏松症作为一种隐匿进展的流行病,正慢慢威胁着人们的生存质量和寿     

骨质疏松症的诊断与治疗

骨质疏松可分为三大类,一类为原发性骨质疏松症,它是随着年龄的增长必然发生的一种生理性退行性病变。第二类为继发性骨质疏松症,它是由其他疾病或药物等一些因素所诱发的骨质疏松症。第三类为特发性骨质疏松症,多见于8～14岁的青少年或成人,多伴有遗传家族史,女性多于男性。妇女妊娠或哺乳期所发生的骨质疏松,也可列入特发性骨质疏松。在中国,骨质疏松症诊断标准如下:以骨密度仪所检测的骨密度值为主要依据,其骨密度值与当地同性别的峰值骨密度相比:减少1～12％为基本正常,减少13～24％为骨质量减少,     

原发性骨质疏松症诊断与治疗

骨质疏松症(osteoporosis OP)是世界范围严重的公共健康问题，已跃居为各种常见病的第7位。随着人口老龄化进程的加速，我国目前已有1．26亿60岁以上老年人．骨质疏松已成为严重威胁着中老年人健康的流行病。我国九五课题七省市4．86万人统计凋查结果，50岁以上人群骨折的发病率为26．6％，60岁以上的骨质疏松总发病率约为     

原发性骨质疏松症诊断与治疗

骨质疏松症(osteoporosis OP)是世界范围严重的公共健康问题,已跃居为各种常见病的第7位.随着人口老龄化进程的加速,我国目前已有1.26亿60岁以上老年人,骨质疏松已成为严重威胁着中老年人健康的流行病.我国九五课题七省市4.86万人统计调查结果,50岁以上人群骨折的发病率为26.6%,60岁以上的骨质疏松总发病率约为22.6%,男性为15%,女性为28.6%,并有逐年增高的趋势.2005年以后骨质疏松症患者可超过1亿,到2050年将成倍增加达2亿1千2百万,占总人口的13.2%.有学者预测2050年将有626万髋部骨折,其中一半以上在亚洲.这些严重后果引起世界各国政府和医学界的高度关注.目前医学界已将防治骨质疏松症预防骨折与治疗高脂血症预防心肌梗死,治疗高血压预防中风这3种疾病放在同样重要位置.骨质疏松症是一种全身性的骨量减少,骨组织的微细结构破坏,导致骨脆性增加,骨强度降低,容易发生骨折的疾病.     

原发性骨质疏松症的诊断与防治

人体骨骼中,无机盐(钙、磷等)约占65％,有机物(主要为胶原纤维)约占35％,有机物在骨骼中起网络构架作用,无机盐沉淀于网状构架上以增加其硬度。骨质疏松症(Osteoporosis,OP)是以骨量(无机盐和有机物)减少,骨组织显微结构破坏,导致骨的脆性增加及弹性和强度下降,并易于发生骨折的一种全身性骨骼疾病。OP分为原发性和继发性两大类,继发性     

原发性骨质疏松症的诊断

原发性骨质疏松症是以骨量减少、骨组织显微结构退化（表现为骨小梁结构破坏、变细和断裂）为特征,以致骨的脆性增高而使骨折危险性增加的一种全身性疾病.目前,我国60岁以上的老龄人口为1.3亿,老年人群中骨质疏松症的患病率已达12.4%（男性8.5%、女性15.7%）,估计全球有2亿人患骨质疏松症.20%的骨质疏松症患者有发生骨质疏松性骨折的可能.据世界卫生组织预测,至2050年,全球半数以上的妇女髋部骨折将发生在亚洲地区.骨质疏松症和骨质疏松性骨折已成为全球共同关注的健康问题.     

诊断骨质疏松症的方法

为推销钙剂,市面“义诊”骨质疏松症者日益增多,为免上当,请看本文。     

绝经后骨质疏松症的诊断与防治

原发性骨质疏松症分绝经后骨质疏松症（ＰＭＯＰ、Ⅰ型）和老年性骨质疏松症（ＳＯＰ、Ⅱ型）两个基本类型。ＰＭＯＰ的发病与绝经有关,其特点是骨的转换增高,骨质流失加快,松质骨变化更显著,易发椎骨及长骨端部的骨折事件。妇女绝经后骨质疏松（ＯＰ）患病率明显增加,约１／３的绝经后妇女受骨质疏松之累,还有相当多的低骨量者,均处于较高的骨折风险之中。美国白人绝经后妇女分别有３０％和５４％患ＯＰ和骨质缺乏（Ｏｓｔｅｏｐｅｎｉａ）。我国妇女绝经后ＯＰ的患病率多在４０％以上。因而骨质疏松症的防治已成为公众关注的热点和…     

原发性骨质疏松症的早期诊断与治疗

骨质疏松症（Ｏｓｔｅｏｐｏｒｏｓｉｓ,Ｏｐ）已被认为是最常见的一种代谢性骨病。在欧洲、美国和日本,估计有７５００万人患有Ｏｐ。美国每年因Ｏｐ而骨折者多达１３０万人,花费超过１３８亿美元［１］。据初步调查推算,我国的Ｏｐ患者约有８４００万。Ａｌｂｒｉｇｈｔ等早在１９４８年就报告,原发性Ｏｐ可分为两种类型,即与绝经雌激素缺乏有关和与衰老有关的二类Ｏｐ。Ｒｉｇｇｓ等１９８２年依据这个概念提出,绝经后松质骨丢失为Ⅰ型Ｏｐ,而与年龄有关的皮质骨和小梁骨都丢失者（女性或男性）为Ⅱ型Ｏｐ。即内源性雌激素缺乏导…     

最新偏头痛分类及诊断标准

偏头痛是一种原发性头痛 ,为一种发作性疾病 ,表现为发作性头痛 ,有些在头痛前有眼前闪光或视野缺损、麻木等先兆症状 ,多数无先兆 ,常伴有恶心、呕吐、畏光、怕声等症状。是世界上最常见的神经系统疾病之一。其患病率在西方国家较高 ,如德国高达 2 8% ,美国 8%～ 12 % ,而东方国家较低 ,如日本为 8%。在我国目前尚缺少严格的流行病学资料 ,在 1986年我国华东六省一市的流行病学调查数据为 986 / 10万 ,该患病率明显低于世界上任何国家和地区 ,但由于该调查在国际头痛学会 1988年第一次公布偏头痛的分类及诊断标准之前 ,缺少可比性 ,因此有…     

Current and future economic burden of osteoporosis in New Zealand

Background

Osteoporosis is recognized as a serious health condition in developed as well as developing countries. There are no accurate estimates of the extent of the burden of osteoporosis in New Zealand. The purpose of this study was to estimate the economic burden of osteoporosis in New Zealand using data from international studies and population and health services information from New Zealand.

Objective

To estimate the number of osteoporotic fractures and cost of treatment and management of osteoporosis and osteoporotic fractures to the health system in New Zealand in 2007 and to project the future burden in 2013 and 2020.

Methods

Hospitalizations for hip fractures were combined with New Zealand census data and estimates from previous studies to estimate the expected number of osteoporotic vertebral, humeral, pelvic and other sites fractures in 2007. Health services usage and costs were estimated by combining data from New Zealand hospitals, the New Zealand Health Survey on the number of people diagnosed with osteoporosis, and the New Zealand Health Information Service (NZHIS) on pharmaceutical treatments. All prices are in New Zealand dollars ($NZ), year 2007 values. Losses in QALYs resulting from osteoporotic fractures were used to indicate the impact on morbidity and mortality. The lost QALYs and economic cost associated with osteoporosis were projected to 2013 and 2020 using population projections from the New Zealand census.

Results

There were an estimated 84 354 osteoporotic fractures in New Zealand in 2007, including 3803 hip and 27994 vertebral fractures. Osteoporosis resulted in a loss of 11249 QALYs. The total direct cost of osteoporosis was $NZ330 million, including $NZ212 million to treat the fractures, $NZ85 million for care after fractures and $NZ34 million for treatment and management of the estimated 70 631 people diagnosed with osteoporosis. Sensitivity analysis suggested the results were robust to assumptions regarding the number of fractures receiving medical treatment. Hospitalization costs represented a significant component of total costs. The cost of treatment and management of osteoporosis is expected to increase to over $NZ391 million in 2013 and $NZ458 million in 2020, with the number of QALYs lost increasing to 13 205 in 2013 and 15 176 in 2020.

Conclusions

Osteoporosis and osteoporotic fractures create a significant burden on the health system in New Zealand. This study highlights the significant scope of the burden of osteoporosis and the potential gains that might be made from introducing interventions to mitigate the burden.     

Glucocorticoid-induced osteoporosis: pathogenesis,diagnosis, and management

Glucocorticoid-induced bone loss is dose- and duration-related, develops rapidly (within months of therapy), and leads to an increased risk of fractures. Moreover, less than one in four patients prescribed oral glucocorticoids receive any treatment to prevent or treat osteoporosis. The American College of Rheumatology recommends bisphosphonate therapy to prevent bone loss in most patients beginning long-term glucocorticoid therapy (prednisone equivalent of > or =5 mg/day for at least 3 months), and in men and postmenopausal women receiving long-term glucocorticoids who have an abnormal bone mineral density (T score below -1). Patients with glucocorticoid-induced osteoporosis are at particularly high risk for fractures, and should be treated aggressively to reduce fracture risk. Risedronate is approved in the United States for both prevention and treatment of glucocorticoid-induced osteoporosis and alendronate is approved for treatment. Both drugs increase bone mass in patients with established glucocorticoid-induced osteoporosis. Risedronate has been shown to significantly reduce the incidence of fractures after 1 year of treatment. Prevention or treatment of glucocorticoid-induced bone loss is recommended for patients at risk.     

Obesity: concept,classification and diagnosis

Obesity is a chronic disease that is characterised by an increase of fat mass and as a result by an increase in weight. There is therefore an increase in the energy reserves of the organism in the form of fat. The term chronic is applied due to its forming part of the group of diseases that we are unable to cure with the therapeutic arsenal that is now available. From an anthropometric point of view, which is habitually used in the clinic, a person is considered to be obese with a Body Mass Index equal to or higher than 30 kg/m2. To be able to evaluate obesity account must be taken not only of the anthropometric aspects but also of the possible genetic factors; the causes of the disease must be studied and the possible existence of associated complications and diseases must be checked. Treatment must always be personalised and adapted to the characteristics and comorbidities presented by the patient. The dominant criteria favourable to therapeutic intervention in obesity are especially based on the demonstration that with a moderate loss of body weight (5-10 %) a notable improvement can be obtained in the comorbidity associated with obesity and in the quality of life of the obese patient.     

Hypersomnia: diagnosis, classification and treatment

Hypersomnia or excessive daytime sleepiness is common in neurological practice and may have different etiologies. Hypersomnia may be defined as sleepiness at an inappropriate time or in an inappropriate situation. It is important to consider that hypersomnia is at times referred to as tiredness or fatigue. A detailed clinical history is essential to reach an accurate diagnosis. A correct diagnosis is necessary to initiate the appropriate treatment considering the negative social and occupational consequences of hypersomnia. Excessive daytime sleepiness syndromes include primary sleep disorders like narcolepsy and hypersomnia secondary to several neurological and psychiatric disorders and also as an adverse effect of numerous drugs.     

基于ARM的超声骨质疏松诊断系统的设计

目的：研究利用定量超声技术检测与诊断骨质疏松的系统。方法：设计采用ARM嵌入式系统,通过超声技术测量并计算足跟骨处的超声速度、宽带超声衰减值和硬度系数。超声速度主要反映骨的结构特性,宽带超声衰减值可以很好地反映骨的密度,而骨硬度指数值能较全面地反映骨强度。结果：系统以ARM处理器为核心,通过对超声波的发射、接收与处理,计算出相应参数,从而判断出骨质是否疏松。结论：通过建立不同年龄、体重、性别正常骨质人群的各参数的数据库,基于ARM的超声测量骨质疏松的系统能够达到精确的临床诊断效果。