降钙素联合单侧穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折的临床研究

目的 探讨降钙素联合单侧穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折的临床疗效。方法 选取2019年1月至2020年12月我院收治的骨质疏松症患者62例作为研究对象。将全部患者随机分为观察组和对照组各31例,对照组患者接受单侧穿刺椎体成形术,观察组在对照组的基础上应用降钙素。随访6个月,比较两组患者治疗前后的骨密度T值、VAS评分、Oswestry功能障碍指数（ODI）、SF-36量表评分及相邻椎体再骨折率。结果 治疗6个月后观察组的骨密度T值显著高于对照组（P<0.05）。经治疗后观察组患者的VAS评分和ODI指数显著低于对照组,SF-36量表评分显著高于对照组（P<0.05）。观察组的相邻椎体再骨折率显著低于对照组（P<0.05）。 结论 降钙素联合单侧穿刺椎体成形术能显著提高骨质疏松性椎体压缩性骨折患者的骨密度,减轻患者疼痛,改善胸腰椎功能,提高生活质量。     

Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 6. Use of bisphosphonates in the treatment of osteoporosis.

OBJECTIVE: To describe the mechanisms of action of bisphosphonates in the treatment of osteoporosis and compare bisphosphonate therapy with other treatments. OPTIONS: The bisphosphonates, etidronate, alendronate, clodronate, pamidronate, tiludronate, ibandronate and risedronate; combined bisphosphonates and estrogen; combined bisphosphonates and calcium supplements. OUTCOMES: Fracture and loss of bone mineral density in osteoporosis; increased bone mass, prevention of fractures and improved quality of life associated with bisphosphonate treatment. EVIDENCE: Relevant clinical studies and reports were examined with emphasis on recent controlled trials. The availability of treatment products in Canada was also considered. VALUES: Reducing fractures, increasing bone mineral density and minimizing side effects of treatment were given a high value. BENEFITS, HARMS AND COSTS: Treatment with bisphosphonates may be an acceptable alternative to ovarian hormone therapy in increasing bone mass and decreasing fractures associated with osteoporosis. Compared with estrogens, bisphosphonates are bone-tissue specific, have equal or greater antiresorptive effect and have few side effects and no known risk for carcinogenesis. They also hold promise in treating male osteoporosis and steroid-induced bone loss. Prolonged, continuous treatment with etidronate may lead to impaired calcification of newly formed bone; therefore, etidronate is administered cyclically. This risk is not present in newer generations of bisphosphonates. RECOMMENDATIONS: Bisphosphonate therapies may be considered as an alternative to ovarian hormone therapy in postmenopausal osteopenic or osteoporotic women who cannot or will not tolerate ovarian hormone therapy. They should also be considered in treating male osteoporosis and steroid-induced bone loss. Combination therapy with estrogen may be effective, although more research is needed. Combination therapy with calcium supplements is recommended. Bisphosphonate therapies should be restricted to postmenopausal patients with osteopenia or established osteoporosis and are not yet recommended for younger perimenopausal women as prophylaxis.     

注射型唑来膦酸盐与鲑鱼降钙素治疗绝经后骨质疏松症的临床比较

目的:比较注射型唑来膦酸盐与鲑鱼降钙素治疗绝经后骨质疏松疗效的临床疗效。方法:将71名绝经后骨质疏松患者给予补充钙剂及维生素D的常规治疗,随机分为唑来膦酸组(34例)及鲑鱼降钙素组(37例)。分别给予唑来膦酸注射液(密固达)5 mg/100 mL共一次,或鲑鱼降钙素隔日肌内注射50 U,连续使用1月后改为,50 U 1次/周,连续使用6个月,对比其疗效。结果:唑来膦酸在缓解骨痛,增加骨密度,减少骨折发生率方面都有一定效果,在半年的观测骨痛缓解及骨密度增加和降钙素组相似,12个月后的观测,缓解骨痛更加明显(P<0.05)。结论:唑来膦酸注射液对绝经后骨质疏松症患者具有缓解骨痛增加骨密度提高生活质量减少骨折发生的作用,是一种有效安全的药物。     

经后路钉棒固定联合抗骨质疏松治疗老年无神经症状性胸腰椎骨折疗效分析

目的:探讨经后路钉棒系统内固定联合抗骨质疏松治疗老年无神经症状性胸腰椎骨折的疗效。方法:38例老年胸腰椎骨折患者均无神经症状,采用经后路钉棒系统内固定及鲑鱼降钙素50 IU肌内注射,1次/d连续使用2周,同时口服钙尔奇D 600 mg,1次/d。患者出院则改为鲑鱼降钙素鼻喷剂继续使用。结果:38例患者,术前经摄X片及CT等检查见伤椎压缩50%或椎管占位30%以上,骨密度检查均存在不同程度的骨质疏松,术后患者的腰背部疼痛明显缓解,X片见椎体高度基本恢复,3个月后腰背部疼痛基本消失,术后3~5个月复查骨密度较术前明显的好转。结论:后路钉棒系统联合抗骨质疏松治疗老年无神经症状性胸腰椎骨折具有恢复椎体高度,稳定脊柱,防止后突畸形,同时有良好止痛和促进成骨作用。     

激素诱导骨质疏松性胸腰椎体骨折PVP后再发骨折分析

目的 探讨激素诱导骨质疏松性胸腰椎体骨折患者行经皮椎体成形术(PVP)后再发骨折的危险因素.方法 选取2010年4月至2015年7月解放军第425中心医院收治的骨质疏松性胸腰椎体骨折患者646例,根据骨折类型分为原发性骨质疏松性胸腰椎体骨折(n=542)和激素诱导骨质疏松性胸腰椎体骨折(n=104),比较两组患者的再发骨折发生率.根据再发骨折发生情况将激素诱导骨质疏松性胸腰椎体骨折患者分为骨折组和无骨折组,对两组患者的临床资料进行单因素和多因素Logistic回归分析.结果 原发性骨质疏松性胸腰椎体骨折患者再发骨折102例(18.82％),激素诱导骨质疏松性胸腰椎骨折患者再发骨折53例(50.96％).骨折组和无骨折组患者的体质量指数、骨密度、骨水泥渗漏、术前椎体裂隙样变、未接受抗骨质疏松治疗比例差异有统计学意义(P＜0.05).骨密度、骨水泥渗漏、术前椎体裂隙样变、未接受抗骨质疏松治疗是影响激素诱导骨质疏松性胸腰椎体骨折患者行PVP后再发骨折的独立危险因素(P＜0.05).结论 激素诱导骨质疏松性胸腰椎体骨折患者再发骨折风险较高,骨密度、骨水泥渗漏、术前椎体裂隙样变、是否接受抗骨质疏松治疗等是再发骨折的主要危险因素.     

骨质疏松性椎体骨折患者血清破骨细胞生成抑制因子和破骨细胞分化因子的表达及意义

目的 探讨骨质疏松性椎体骨折患者血清破骨细胞生成抑制因子(osteoclast suppressor,OCIF)和破骨细胞分化因子(osteoclast differentiation factor,ODF)的表达及意义。 方法 选择衢州市人民医院2013年1月—2016年12月符合标准的骨质疏松性椎体骨折患者70例为骨质疏松组,非骨质疏松性椎体骨折患者70例为对照组。采用双抗体夹心酶联免疫吸附实验(Double antibody sandwich enzyme-linked immunosorbent assay,ELISA)法测定血清OCIF和ODF水平。采用双能X线骨密度仪测量腰椎正位总体L_1-4骨密度及左侧股骨颈骨密度。采用SPSS20.0统计软件对数据进行分析。 结果 骨质疏松组血清OCIF和ODF水平均高于对照组(均P<0.05)。骨质疏松组腰椎正位骨密度和股骨颈骨密度均低于对照组(均P<0.05)。骨质疏松患者血清OCIF、ODF水平与腰椎正位骨密度、股骨颈骨密度均呈负相关(均P<0.05)。骨质疏松患者血清OCIF、ODF水平与骨折程度无显著相关性(均P>0.05)。 结论 骨质疏松性椎体骨折患者血清OCIF、ODF水平升高,血清OCIF、ODF水平与骨质疏松性椎体骨折患者的骨密度关系密切,与骨折的严重程度关系不大。      

Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 7. Fluoride therapy for osteoporosis.

OBJECTIVE: To present the latest findings on the use of fluoride in the treatment of osteoporosis. OPTIONS: Plain sodium fluoride (NaF), enteric-coated sodium fluoride (EC-NaF), sodium monofluorophosphate (Na2FPO4), slow-release sodium fluoride (SR-NaF); fluoride with a calcium supplement. OUTCOMES: Fracture and loss of bone mineral density in osteoporosis; increased bone mass, prevention of fractures and improved quality of life associated with treatment. EVIDENCE: Relevant clinical studies and reports were examined, with an emphasis on recent prospective, randomized, controlled trials. Clinical practices in European countries were also considered. VALUES: Reducing fractures, increasing bone mineral density and minimizing side effects of treatment were given a high value. BENEFITS, HARMS AND COSTS: NaF therapy stimulates bone formation and may be effective in preventing osteoporotic fractures. It may be an acceptable alternative treatment to estrogen or bisphosphonate therapy and useful in premenopausal and corticosteroid-induced osteoporosis and in some patients with mild osteogenesis imperfecta. Toxic effects are dependent on formulation and dosage. They include a range of gastrointestinal and musculoskeletal conditions. EC-NaF is associated with less toxicity than plain NaF; its gastrointestinal toxicity is negligible. Na2FPO4 has no gastrointestinal toxicity, but can give rise to skeletal toxicity. SR-NaF appears to have no side effects when given intermittently. Carcinogenicity has not been found in vivo with fluoride therapy, despite in vitro results. RECOMMENDATIONS: New data indicate that fluoride therapy should be re-evaluated as a potentially effective treatment of osteoporosis with minimal side effects. More studies are needed of slow-release fluoride formulations, intermittent treatment schedules and calcium supplementation of fluoride. Studies should be undertaken to see if it is advantageous to initiate treatment with antiresorptive agents before or in combination with fluoride. Conclusive data have not been presented regarding the benefit of any specific type of calcium supplement. Further studies on the basic mechanism of action of fluoride on the skeleton are necessary to evaluate fluoride's potential to stimulate bone formation therapeutically.     

Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 4. Calcium nutrition and osteoporosis.

OBJECTIVE: To recommend appropriate levels of calcium intake in light of the most recent studies. OPTIONS: Dietary calcium intake, calcium supplementation, calcium and vitamin D supplementation; ovarian hormone therapy in postmenopausal women. OUTCOMES: Fracture and loss of bone mineral density in osteoporosis; increased bone mass, prevention of fractures and improved quality of life associated with osteoporosis prevention. EVIDENCE: Relevant clinical studies and reports were examined, in particular those published since the 1988 Osteoporosis Society of Canada position paper on calcium nutrition. Only studies in humans were considered, including controlled, randomized trials and prospective studies, using bone mass and fractures as end-points. Studies in early and later phases of skeletal growth were noted. The analysis was designed to eliminate menopause as a confounding variable. VALUES: Preventing osteoporosis and maximizing quality of life were given a high value. BENEFITS, HARMS AND COSTS: Adequate calcium nutrition increases bone mineral density during skeletal growth and prevents bone loss and osteoporotic fractures in the elderly. Risks associated with high dietary calcium intake are low, and a recent study extends this conclusion to the risk of kidney stones. Lactase-deficient patients may substitute yogurt and lactase-treated milk for cow's milk. True milk allergy is probably rare; its promotion of diabetes mellitus in susceptible people is being studied. RECOMMENDATIONS: Current recommended intakes of calcium are too low. Revised intake guidelines designed to reduce bone loss and protect against osteoporotic fractures are suggested. Canadians should attempt to meet their calcium requirements principally through food sources. Pharmaceutical calcium supplements and a dietician's advice should be considered where dietary preferences or lactase deficiency restrict consumption of dairy foods. Further research is necessary before recommending the general use of calcium supplements by adolescents. Calcium supplementation cannot substitute for hormone therapy in the prevention of postmenopausal bone loss and fractures. Adequate amounts of vitamin D are necessary for optimal calcium absorption and bone health. Elderly people and those who use heavy sun screens should have a dietary intake of 400 to 800 IU of vitamin D per day.     

鲑鱼降钙素鼻喷剂治疗绝经后骨质疏松疗效观察

目的观察鲑鱼降钙素治疗对绝经后骨质疏松症骨密度的影响.方法收集98例绝经后妇女,应用鲑鱼降钙素治疗78例绝经后骨质疏松症患者12周,A组24人鼻喷鲑鱼降钙素,B组54人每天肌注鲑鱼降钙素,两组均加服钙剂,C组20人单独服用钙剂(2 g/d).观察治疗前后腰椎骨密度的变化.结果两治疗组L1～4骨密度在治疗前后差异均有显著性,C组各观察指标无明显变化.结论鲑鱼降钙素鼻喷剂治疗绝经后骨质疏松症可提高骨密度,改善骨代谢.     

Calcitonin and the treatment of osteoporosis.

Calcitonin, a potent inhibitor of bone resorption, is an important agent for the treatment of osteoporosis. An analgesic effect of salmon calcitonin has also been reported. The recent development of calcitonin nasal spray should eliminate the need for injections.     

绝经后骨质疏松症与血管紧张素II的相关因素分析

目的：探讨血管紧张素II对骨质疏松症患者与社区正常人群骨质疏松与骨质疏松性骨折风险的相关性。方法：对骨质疏松症患者与社区正常人群实施双能X线骨密度测定,并采用酶联免疫吸附试验进行血管紧张素II的测定。进一步通过统计学分析对相关性进行了验证。结果：骨质疏松患者骨密度水平与血25羟维生素D水平和血管紧张素II水平相关,骨质疏松患者骨密度低、且骨折风险高于对照组。单因素分析显示血管紧张素II影响骨质疏松患者的骨密度与骨折风险。结论：进一步深入研究肾素血管紧张素系统相关组分对骨质疏松发病机制中的作用对疾病预防和治疗有着深远意义。     

Clinical practice guidelines for the diagnosis and management of osteoporosis. Scientific Advisory Board, Osteoporosis Society of Canada.

OBJECTIVE: To recommend clinical practice guidelines for the assessment of people at risk for osteoporosis, and for effective diagnosis and management of the condition. OPTIONS: Screening and diagnostic methods: risk-factor assessment, clinical evaluation, measurement of bone mineral density, laboratory investigations. Prophylactic and corrective therapies: calcium and vitamin D nutritional supplementation, physical activity and fall-avoidance techniques, ovarian hormone therapy, bisphosphonate drugs, other drug therapies. Pain-management medications and techniques. OUTCOMES: Prevention of loss of bone mineral density and fracture; increased bone mass; and improved quality of life. EVIDENCE: Epidemiologic and clinical studies and reports were examined, with emphasis on recent randomized controlled trials. Clinical practice in Canada and elsewhere was surveyed. Availability of treatment products and diagnostic equipment in Canada was considered. VALUES: Cost-effective methods and products that can be adopted across Canada were considered. A high value was given to accurate assessment of fracture risk and osteoporosis, and to increasing bone mineral density, reducing fractures and fracture risk and minimizing side effects of diagnosis and treatment. BENEFITS, HARMS AND COSTS: Proper diagnosis and management of osteoporosis minimize injury and disability, improve quality of life for patients and reduce costs to society. Rationally targeted methods of screening and diagnosis are safe and cost effective. Harmful side effects and costs of recommended therapies are minimal compared with the harms and costs of untreated osteoporosis. Alternative therapies provide a range of choices for physicians and patients. RECOMMENDATIONS: Population sets at high risk should be identified and then the diagnosis confirmed through bone densitometry. Dual-energy x-ray absorptiometry is the preferred measurement technique. Radiography can be adjunct when indicated. Calcium and vitamin D nutritional supplementation should be at currently recommended levels. Patients should be counselled in fall-avoidance techniques and exercises. Immobilization should be avoided. Guidelines for management of acute pain are listed. Ovarian hormone therapy is the therapy of choice for osteoporosis prevention and treatment in postmenopausal women. Bisphosphonates are an alternative therapy for women with established osteoporosis who cannot or prefer not to take ovarian hormone therapy.     

阿仑膦酸钠治疗绝经后骨质疏松症的疗效分析

目的分析阿仑膦酸钠治疗绝经后骨质疏松症的临床疗效。方法将80例绝经后骨质疏松患者随机分成观察组和对照组,观察组给予阿伦膦酸钠片,10mg/d,对照组给予安慰剂,两组患者均同时加服钙尔奇D600,以6个月为一个疗程,连续治疗12个月。观察两组患者治疗前后骨密度和骨代谢指标、新骨折发生情况及临床不良反应。结果两组患者经2个疗程治疗后,骨密度、血骨钙素、C端交联多肽水平变化比较具有统计学意义,P〈0.05;两组患者均未见新骨折发生和明显不良反应。结论阿伦磷酸钠治疗绝经后骨质疏松症具有明显的抑制骨吸收作用,能够减少绝经后妇女腰椎骨量的流失,副作用较少,是绝经后妇女预防和治疗骨质疏松的理想药物。     

骨质疏松性胸腰椎体骨折部位及密度对下腰部位疼痛的影响

目的 探讨骨质疏松性胸腰椎体骨折部位及密度对下腰部位疼痛的影响.方法 回顾性分析2010年1月至2014年12月在我院脊柱骨科行经皮椎体后凸成形术(PKP)的106例(114个骨折椎体)骨质疏松性胸腰椎体骨折患者的临床资料,按照年龄分为<70岁组(26例)、70~79岁组(58例)和>80岁组(22例),平均随访时间2.1年.收集患者的一般资料,记录PKP术后疼痛发生率,骨密度(BMD)和T值进行测定,采用疼痛视觉模拟评分(VAS)对患者术后下腰部疼痛情况进行评估.结果 106例骨质疏松性胸腰椎体骨折患者中单一骨折98例,2个椎体骨折8例;三个年龄组患者的骨密度、T值随着年龄的增加而逐渐降低,任意两年龄组的骨密度、T值经比较差异均具有统计学意义(P<0.05);PKP术后,下腰部疼痛发生率为18.9%(20/106);三个年龄组患者下腰痛发生率、疼痛视觉模拟评分均随着年龄的增加而逐渐上升,任意两年龄组的下腰痛发生率、疼痛视觉模拟评分经比较差异均具有统计学意义(P<0.05);三个年龄组患者随着骨密度和T值的下降,疼痛视觉模拟评分呈现上升的趋势.骨折部位距离下腰部位越近则疼痛发生率越高.结论 骨质疏松性胸腰椎体骨折患者PKP术后有16.0%的患者发生下腰痛,椎体骨折部位及骨密度与下腰痛的发生密切相关.     

鲑鱼降钙素联合恒古骨伤愈合剂治疗腰椎OPF疗效分析

目的探讨鲑鱼降钙素联合恒古骨伤愈合剂治疗腰椎骨质疏松性骨折（OPF）的疗效。方法自2007年11月至2009年12月简阳市人民医院骨科共收治82例腰椎骨质疏松性骨折,随机分成治疗组和对照组,治疗组42例给予鲑鱼降钙素和恒古骨伤愈合剂联合治疗,对照组40例仅给予鲑鱼降钙素治疗,比较2组的疼痛缓解效果。结果82例治疗前用视觉模拟评分法（VAS）评分为6～9分,2组间的疼痛评分差异无统计学意义（P〉0．05）。治疗后3、5、8、15d,2组疼痛VAS评分分别经秩和检验差异有统计学意义（P〈0．01）。治疗组不但疼痛缓解快,3个月后复查骨矿物密度改善程度亦明显优于对照组。结论鲑鱼降钙素联合恒古骨伤愈合剂治疗腰椎骨质疏松性骨折具有良好止痛和促进成骨作用,是一种安全、有效的方法。     

骨质疏松的健康管理发展现状及挑战

骨质疏松是引起老年人骨质疏松性骨折的主要原因,严重影响患者的生活质量、增加经济负担。引起骨质疏松的主要原因包括骨密度下降、骨组织显微结构的破坏及骨强度减弱等。目前针对骨密度下降这一原因的主要治疗手段是使用抗骨吸收药物(如双膦酸盐类药物、降钙素)、促进骨形成药物(甲状旁腺激素)以及某些中药等,然而药物治疗效果并不理想。尽管可以通过手术进行干预,但依旧存在诸多术后并发症。近年来随着三级预防思想的树立,从一级预防的角度针对高危人群来进行骨质疏松的健康管理成为当前预防骨质疏松症及相关骨折的主流方法。本文主要从骨质疏松健康管理的来源与患者和医务人员的相互关系2个方面简要介绍骨质疏松健康管理的一些措施及其在当前发展中所遇到的挑战。此外,绝经后女性的骨质疏松症主要是由于雌激素减少导致骨密度下降,因而在预防措施上与老年性骨质疏松有所不同,予以分开阐述。进一步的发展目前需要解决我国三级诊疗体系尚不完善的现状并制定出更科学的骨质疏松评定标准以及加强患者对健康管理方案中饮食和生活习惯的依从性等。此外,从雌激素的类型、剂量、持续使用时间以及个体情况等方面改善并发展雌激素在围绝经期女性骨质疏松健康管理中的应用,最终发挥健康管理在骨质疏松症及相关骨折中的一级预防作用。      

阿法骨化醇对老年女性骨质疏松性髋部骨折骨代谢和骨密度的影响研究

目的探讨阿法骨化醇治疗老年女性骨质疏松性髋部骨折的临床效果及其对骨代谢、骨密度的影响。方法 64例老年女性骨质疏松性髋部骨折患者被随机分为治疗组和对照组各32例,2组患者在行内固定手术后2周开始服药治疗,对照组给予口服维D钙,治疗组给予阿法骨化醇联合维D钙治疗,2组疗程均为1年。检测2组治疗前后的腰椎正位、健侧股骨颈、Wards三角区的骨密度和骨代谢指标(BALP、VDR、TRACP-5b)。结果治疗组治疗后腰椎正位、健侧股骨颈、Wards三角区的骨密度较治疗前显著上升(P<0.05),而对照组无显著改善(P>0.05),且治疗组与对照组比较差异有统计学意义(P<0.05)。治疗组治疗后血清BALP、VDR水平较治疗前显著上升(P<0.01),血清TRACP-5b水平较治疗前显著下降(P<0.01),而对照组无显著改善(P>0.05),且治疗组与对照组比较差异有统计学意义(P<0.01)。结论阿法骨化醇治疗老年女性骨质疏松性髋部骨折具有抑制骨吸收和提高骨密度的作用。     

Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 2. The use of bone density measurement in the diagnosis and management of osteoporosis.

OBJECTIVE: To determine the best method of diagnosing osteoporosis and determining fracture risk and to promote standards in the use of bone densitometry and the reporting of results. OPTIONS: Methods of bone mineral density measurement: dual-energy x-ray absorptiometry (DXA), radiographic absorptiometry, single-photon absorptiometry, dual-photon absorptiometry, quantitative computed tomography, quantitative ultrasound, neutron activation analysis. The options of using bone densitometry in individual patient management and as a mass screening tool are also considered. OUTCOMES: Appropriate use of densitometry to promote accurate diagnosis and assessment of fracture risk and timely, appropriate treatment. EVIDENCE: Relevant clinical studies and reports were examined. Clinical practice in Canada was also considered. VALUES: Accurate assessment of osteoporotic fracture risk and diagnosis of osteoporosis and assuring low exposure to medical radiation were given a high value. BENEFITS, HARMS AND COSTS: Early diagnosis through bone density measurement allows proper management of osteoporosis to minimize injury and disability, improve quality of life and reduce the personal and social costs associated with the condition. Potential harms include radiation exposure and cost. The harms and costs of appropriate use of DXA are minimal compared with the harms and costs associated with osteoporosis. RECOMMENDATIONS: Bone mineral density should be measured only to assist in making a clinical management choice. DXA is the best method of measuring bone density and, thus, the best available indicator of osteoporotic fracture risk. Plain radiographs may supplement DXA if there is a specific reason for their use. Measurement of the lumbar spine and femoral neck is standard, but a different site or a single measurement is recommended in specific cases. Unless accelerated bone loss is suspected, DXA should be repeated every 2 to 4 years for patients receiving ovarian hormone therapy and 1 to 2 years for patients undergoing bisphosphonate therapy. Measurements and reporting of results must be standardized. Reports should refer to the World Health Organization's recommended definitions of osteopenia and osteoporosis and provide actual measurement and its relation to peak bone mass.     

骨质疏松性骨折药物治疗的临床观察

目的探讨应用药物治疗骨质疏松性骨折的疗效。方法对60例患者给予补钙治疗,同时服用骨化三醇+降钙素。于用药半年、1年后通过拍摄胸腰椎片、骨密度检查,以及骨折发生情况评价疗效。结果治疗前60例患者的腰椎骨密度值平均为(0.679±0.100),治疗半年后平均(0.780±0.110),治疗后1年平均为(0.765±0.099)。治疗1年后及半年后骨密度值较治疗前差异有统计学意义(P<0.01),治疗期间未发生脊柱其他节段压缩骨折。结论降钙素+维生素D+钙剂治疗骨质疏松性脊柱压缩性骨折,能有效缓解疼痛,增加骨密度。     

健康教育对骨质疏松骨折患者术后骨质疏松认知、自我效能及骨折疗效的影响

目的：分析健康教育对骨质疏松骨折患者术后骨质疏松认知、自我效能及骨折疗效的影响。方法选取骨质疏松的骨折患者142例,随机分为观察组和对照组各71例,观察组实施综合健康教育,比较两组的骨质疏松症知识问卷（OKT）、骨质疏松症自我效能量表（OSES）、腰椎骨密度及骨折疗效情况。结果术后3、6个月观察组患者的OKT评分均显著高于对照组（P〈0.05）,术后3、6个月观察组OSES的锻炼效能、钙效能及总分均显著高于对照组（P〈0.05）,术后3、6个月观察组患者的腰椎骨密度均显著高于对照组（P〈0.05）,术后3个月观察组患者的骨折疗效显著优于对照组（P〈0.05）。结论骨质疏松对骨折术后预后产生不良影响,通过对患者进行骨折及骨质疏松相关健康教育有助于增强患者对骨质疏松的认知和自我效能,提高骨密度及骨折疗效。