人甲状旁腺激素对去卵巢大鼠股骨骨量的影响(论著摘要)

甲状旁腺激素（PTH）通常被认为是刺激破骨细胞骨吸收从而引起骨分解代谢增强的激素，但早在30年代Selye等就报告PTH也有增加骨形成的作用。特别是最近10多年来，随着对骨质疏松症危害性认识的提高，人们在寻找有效治疗骨质疏松症药物时，对于PTH的成骨作用愈加重视。研究发现，PTH刺激骨形成的作用均出现在间歇注射过程中，而PTH持续灌注则会使皮质骨量丢失，这两种使用方式导致相反结果的原因尚不清楚，可能与间歇注射更接近PTH的生理性脉冲分泌形式有关。本文着重观察PTH的骨合成作用。选用10月龄Wlstar健康雌性大鼠96只，共分…     

甲状旁腺激素治疗骨质疏松症的研究进展

骨质疏松症(osteoporosis,OP)是一种以骨量减少,骨组织微结构系统性损伤为特点的全身性骨骼疾病,目前临床上对OP的治疗,主要通过抑制骨吸收和促进骨形成来提高骨密度,目前应用的治疗骨质疏松症的药物中,甲状旁腺激素(PTH)在维持骨稳态的过程中具有独特的双重调节作用,一方面可增加成骨细胞的数量,促进骨生长因子释放,从而促进骨形成,增加骨量,另一方面也可增强破骨细胞活性,促进骨吸收,使骨钙释放入血,因此,PTH成为骨代谢与治疗骨质疏松症相关研究的热点之一。本文简要介绍了PTH对骨代谢的调节机制,以及在实验动物和临床研究中的作用。     

骨质疏松症的药物治疗

骨质疏松症是一种骨退行性病变,其发生主要与骨吸收和骨重建失衡有关。根据骨质疏松症的发病机制的不同,临床治疗药物主要分为基本补充剂、抗骨吸收药物和促骨形成药物。钙剂和维生素D是药物治疗的基础;抗骨吸收药物包括双磷酸盐、雌激素及其受体调节剂、降钙素;甲状旁腺激素为促骨形成药物;锶盐、维生素K2等兼有抗骨吸收和促骨形成的作用。特殊人群以及不同类型的骨质疏松症治疗要注意药物的适用性和针对性。     

甲状旁腺切除术改善尿毒症患者骨质疏松症疗效观察

目的 观察甲状旁腺切除术治疗尿毒症继发甲状旁腺功能亢进并导致骨质疏松症患者的临床疗效。方法采用自身对照研究方法,选择我院尿毒症继发甲状旁腺功能亢进并导致骨质疏松症患者,使用甲状旁腺切除术方法,设术前为观察组,术后3个月、6个月为对照组,以骨密度值、骨痛症状、甲状旁腺激素(PTH)、血钙、血磷为监测指标数据评估疗效。结果甲状旁腺切除术后此类患者血钙维持在正常范围、血磷、血iPTH水平明显下降,临床骨痛、骨密度等明显改善。结论甲状旁腺切除术安全,有效治疗尿毒症并发症导致的骨质疏松症,控制体内血磷和血钙水平,缓解骨质疏松症状,明显改善生活质量。     

降钙素治疗老年血液透析患者骨代谢紊乱26例

目的:观察降钙素对维持性血液透析(MDH)骨代谢紊乱的有效性和安全性。方法:26例维持性血液透析患者给予降钙素20 u皮下注射2次/周,加服碳酸钙750 mg/d,经3个月治疗,观察患者治疗前及治疗后血钙、血磷及甲状旁腺激素(PTH),同时观察患者骨痛的变化,并进行统计学分析。结果:26例患者全部完成观察治疗。治疗过程中,血钙均处于正常水平,与治疗前比较差异无统计学意义(P>0.05)。血磷较治疗前下降,差异有统计学意义(P<0.05)。PTH与治疗前比较,差异有统计学意义(P<0.01)。该药不良反应主要为恶心、呕吐5例(19.23%,5/26),头晕、颜面潮红、心慌各1例(3.85%,1/26)。结论:降钙素治疗维持性血液透析患者骨代谢紊乱,可以有效降低血磷及甲状旁腺素(PTH)水平,有效缓解患者的骨痛症状,同时应用降钙素是安全的。     

骨质疏松症治疗药物的研究进展

随着对骨质疏松症发病机制、病理学特征等进一步认识,治疗药物的研究也不断深入。临床治疗骨质疏松症的药物可分为促进骨形成药物如甲状旁腺激素、他汀类等,抑制骨吸收药物如雌激素、选择性雌激素受体调节剂、双膦酸盐类、狄诺塞麦等,既能抑制骨吸收又能促进骨形成的药物如锶盐,钙剂和维生素D及衍生物以及中医药等。文章对以上目前国内外治疗骨质疏松的药物研究进展做一综述。     

血液灌流治疗对尿毒症患者血浆甲状旁腺激素（PTH）的清除效果

目的：探究血液灌流治疗对尿毒症患者血浆甲状旁腺激素（plasma parathyroid hormone,PTH）的清除效果。方法选取尿毒症患者64例,随机分为对照组和观察组,各32例。对照组给予血液透析治疗,观察组给予血液透析联合血液灌注治疗,检测2组患者治疗前后的血浆PTH水平。结果对照组治疗前血浆PTH水平（537.78±49.10）,治疗后（568.75±39.54）,差异无统计学意义;观察组治疗前血浆PTH水平（535.25±50.13）,治疗后（261.17±41.89）,差异有统计学意义（P＜0.05）;血浆PTH水平治疗前组间比较,差异无统计学意义;血浆PTH水平治疗后组间比较,差异有统计学意义（P＜0.05）。对照组治疗12周后,骨痛、皮肤瘙痒、心慌、气短等症状无明显改善,观察组治疗12周后,骨痛、皮肤瘙痒、心慌、气短等症状明显缓解。结论血液灌注治疗对尿毒症患者并发甲状旁腺功能亢进所致的甲状旁腺激素（PTH）在血浆中的升高来说,可以有效的清除患者血浆内的甲状旁腺激素（PTH）,且对于该疾病所引起的骨痛、皮肤瘙痒、心慌、气短等症状也有一定的改善,有效减轻了患者的痛苦,并在很大程度上提高了患者的生活质量,可以考虑在临床上借鉴及使用。     

甲状旁腺激素对心血管系统的作用

甲状旁腺激素(PTH)是由甲状旁腺主细胞合成和分泌的多肽激素,通过对靶器官骨骼和肾脏的作用,维持血钙的相对稳定。近年来,一些研究资料表明PTH还作用于骨、肾以外的其它器官。如PTH能扩张离体和在体血管,具有降低动脉血压,增加心率和增强心肌收缩力的作用。心血管系统可能成为PTH新的靶器官系统。本文拟就PTH对心血管活动的影响作一简单综述。 一、对血管的作用 早在1968年,Charbon曾报道甲状旁腺提取液具有降低动脉血压的作用。Pang等(1980)证实PTH能使狗动脉血压迅速下降。Nickols等(1983)     

重组人甲状旁腺素(1-34)临床研究进展

骨质疏松症是常见的代谢性骨病之一。作为第一个被批准使用的促骨形成药物,重组人甲状旁腺素(1-34)小剂量具有增加骨密度,改善骨结构,减少脊椎和椎外骨折发生率的作用,成为骨质疏松症治疗的新热点。新近的临床研究还证实它还可与抗骨吸收药序贯治疗。现分别从药代动力学、药理机制、临床应用和不良反应等四方面对重组人甲状旁腺素(1-34)进行阐述。     

甲状旁腺激素与骨质疏松症

甲状旁腺激素(Parathyroidhormone,PTH)是调节钙磷代谢,维持机体钙平衡的主要激素,其外周代谢主要在肾脏、骨及肝脏中进行,并直接作用于骨和肾,靶细胞为成骨细胞及肾小管细胞。成骨细胞膜上有PTH受体能结合PTH1-84和PTH1-34两片段,目前认为骨对PTH1-34优先摄取并及时作出反应。肾小管细胞膜上亦有此两种肽段的受体,能与PTH1-84和PTH1-34结合,且可被重吸收,在此处PTH1-84可进行降解。肝脏不是PTH的主要靶组织,只摄取PTH1-34且是其降解成氨基端及羧基端的主要场所。　　PTH对骨的作用一方面是增加破骨细胞的数目及活力,促进骨吸…     

Recombinant PTH: A Study of the Outcome of Teriparatide Therapy for 138 Patients with Osteoporosis

Introduction

Osteoporosis results in significant morbidity and mortality for a large number of patients within Northern Ireland. Recombinant PTH (Teriparatide) is one of a growing number of treatment options for the disease.

Methods

A retrospective analysis was carried out for all patients who had been commenced on Teriparatide since it was first used in the Belfast Health and Social Care Trust (BHSCT) in 2007. Patient demographics, clinical history and prior treatment were recorded prior to an eighteen month treatment protocol. Outcome measures including bone densitometry, bone turnover markers and health status were assessed on commencement and completion.

Results

138 patients have commenced teriparatide therapy since 2007 (9 male, 129 female). At the time of analysis 60 patients had completed treatment, 53 patients were receiving ongoing treatment and 25 patients did not complete the 18 month course. On completion vertebral bone mineral density (BMD) had increased by 8.3% while femoral neck BMD had increased by 3.5%. Bone turnover markers demonstrated a significant increase of bone formation and resorption at 4 months, with a smaller increase at 18 months. Health outcome measures (EuroQoL-5 and patient visual analogue scale) indicated improvement in the quality of life of patients of those who completed the treatment course.

Conclusions

Experience in the BHSCT with teriparatide since 2007 demonstrates improvement in BMD comparable to published data, changes in bone turnover markers consistent with increased bone remodeling and better health outcomes for patients.     

骨质疏松症及其干预治疗对种植体骨结合影响的研究进展

种植牙的成功依赖于种植体周围良好的骨质和足够的骨量,而骨质疏松症作为机体老化过程的表现,骨的质量与数量都发生了蜕变,是影响种植牙成功的风险因素之一。该种状态下种植体骨结合质量及其抗骨质疏松药物对种植体骨结合的影响,是近年来国内外研究的热点之一。现就骨质疏松症与颌骨的相关关系,骨质疏松及其药物干预对种植体骨结合的影响等几个方面的研究进展进行综述。     

Prevalent and emerging therapies for osteoporosis

Osteoporosis and fractures associated with it constitute a real and serious socio-medical problem, which only recently has come to the forefront of social consciousness. With increasing number of exservicemen and their dependents, osteoporosis management has become very important in our setup. Currently available pharmacological therapies for prevention of fragility fractures are limited in scope, efficacy and acceptability to patients. Oral bisphosphonates are the standard treatment for osteoporosis which are associated with significant gastrointestinal side effects and thus poor patient compliance. Newer regimens, including intravenous (IV) formulations of bisphosphonates, have successfully come in vogue with greater patient compliance and equal or better benefits. The real need in osteoporosis treatment is for additional anabolic drugs. The only currently approved anabolic agent for treating osteoporosis is teriparatide (recombinant human parathyroid hormone 1–34), which stimulates new bone formation. Considerable efforts are being made to develop new, more effective treatment for osteoporosis. These novel drugs under trial include those primarily inhibiting osteoclastic bone resorption (like bisphosphonates) such as inhibitors of receptor activator of nuclear factor-kappa B ligand (RANKL) signalling, cathepsin K inhibitors, c-Src kinase inhibitors, integrin inhibitors, chloride channel inhibitors and the drugs with osteo-anabolic actions such as orally active parathyroid hormone (PTH) analogues, calcium sensing receptor antagonists, PTH-related peptide analogues and agents that induce osteoblast anabolism via pathways involving key, recently identified, molecular targets (wnt low-density lipoprotein receptor-related protein-5 signalling; sclerostin antibodies).     

Prevalent and Emerging Therapies for Osteoporosis

Osteoporosis and fractures associated with it constitute a real and serious socio-medical problem, which only recently has come to the forefront of social consciousness. With increasing number of exservicemen and their dependents, osteoporosis management has become very important in our setup. Currently available pharmacological therapies for prevention of fragility fractures are limited in scope, efficacy and acceptability to patients. Oral bisphosphonates are the standard treatment for osteoporosis which are associated with significant gastrointestinal side effects and thus poor patient compliance. Newer regimens, including intravenous (IV) formulations of bisphosphonates, have successfully come in vogue with greater patient compliance and equal or better benefits. The real need in osteoporosis treatment is for additional anabolic drugs. The only currently approved anabolic agent for treating osteoporosis is teriparatide (recombinant human parathyroid hormone 1–34), which stimulates new bone formation. Considerable efforts are being made to develop new, more effective treatment for osteoporosis. These novel drugs under trial include those primarily inhibiting osteoclastic bone resorption (like bisphosphonates) such as inhibitors of receptor activator of nuclear factor-kappa B ligand (RANKL) signalling, cathepsin K inhibitors, c-Src kinase inhibitors, integrin inhibitors, chloride channel inhibitors and the drugs with osteo-anabolic actions such as orally active parathyroid hormone (PTH) analogues, calcium sensing receptor antagonists, PTH-related peptide analogues and agents that induce osteoblast anabolism via pathways involving key, recently identified, molecular targets (wnt low-density lipoprotein receptor-related protein-5 signalling; sclerostin antibodies).Key Words: Osteoporosis, Prevalent, Emerging therapies     

特立帕肽通过cAMP/PKA/CREB信号通路调控高糖微环境下的成骨细胞分化

目的 探讨特立帕肽对高糖微环境下小鼠胚胎成骨细胞（MC3T3-E1）分化的影响及作用机制。方法 将MC3T3-E1细胞分为正常糖组（NG,5.5 mmol/L葡萄糖）、NG+特立帕肽组（5.5 mmol/L葡萄糖+10 nmol/L特立帕肽）、高糖组（HG,25 mmol/L葡萄糖）、HG+特立帕肽组（25 mmol/L葡萄糖+10 nmol/L特立帕肽）和HG+特立帕肽+PKA抑制剂组（25 mmol/L葡萄糖+10 nmol/L特立帕肽+20μmol/L H-89）。CCK-8法检测细胞增殖;ELISA实验检测各组cAMP水平;试剂盒检测碱性磷酸酶（ALP）活性;茜素红染色检测细胞矿化结节生成情况;鬼笔环肽染色后观察细胞骨架;Real-time PCR检测细胞中PKA、CREB、RUNX2和Osx的mRNA表达水平。结果 各组细胞增殖能力差异无统计学意义（P>0.05）。与NG组相比,NG+特立帕肽组细胞cAMP水平升高（P<0.05）,ALP活性增强（P<0.05）,茜素红矿化结节生成能力增强（P<0.05）,细胞骨架清晰程度有所提升,PKA、CREB、R...     

肉苁蓉苯乙醇苷类成分抗骨质疏松作用机制研究进展

肉苁蓉是一种珍贵的滋补类药材,素有"沙漠人参"的美誉,具有极高的药用价值和食用价值.药理学研究已确认肉苁蓉具有抗氧化、抗炎、抗疲劳、抗衰老、抗骨质疏松、润肠通便、保肝、免疫调节等药理作用,其中苯乙醇苷类是其主要活性成分之一.近年来,肉苁蓉苯乙醇苷类成分抗骨质疏松的作用得到广泛关注,松果菊苷和毛蕊花糖苷是其代表性成分,笔...     

狗脊生、制品乙酸乙酯提取物抗骨质疏松药效学研究

目的：研究狗脊生、制品的乙酸乙酯提取物的抗骨质疏松作用。方法：将SD雌性大鼠切除卵巢造成骨质疏松动物模型,用狗脊生、制品的乙酸乙酯提取物溶液灌胃给药,研究其对卵巢去势大鼠的抗骨质疏松作用。结果 ：狗脊制品乙酸乙酯提取物对卵巢去势大鼠具有显著的抗骨质疏松作用,狗脊生品乙酸乙酯提取物对卵巢去势大鼠具有一定的抗骨质疏松作用。结论：狗脊生、制品的乙酸乙酯提取物具有一定的抗骨质疏松作用。     

抗骨松穴位贴剂对实验性骨质疏松大鼠的防治作用

目的探讨抗骨松穴位贴剂(AOAP)拮抗实验性骨质疏松(OP)、"破骨大于成骨"、逆转"阳杀阴藏"的机理.方法.采用注射地塞米松(Dex)建立OP模型,用AOAP外贴穴位、非经非穴位,并与口服补肾方药比较治疗OP,以血清T/E2、骨密度、CT/PTH,骨形态计量学参数TBV、TBS、TFS、LBGR、AFS、MAR、BFR、TRS的变化为衡量指标.结果.AOAP能提高T/E2、CT/PTH和骨密度,升高TBV、TBS、TFS、LBGR、AFS、MAR 、BFR,降低TRS.结论.AOAP可以通过"多位点相关集合效应"调控影响骨代谢的内分泌,提高T/E2、CT/PTH水平,可以逆转OP"搬家",拮抗骨细胞"阳杀阴藏"的过程,增加骨密度.     

促甲状腺激素抑制治疗可能影响骨骼健康，分化型甲状腺癌该如何科学管理？

分化型甲状腺癌（DTC）是患病率最高的甲状腺癌,DTC术后采取促甲状腺激素（TSH）抑制治疗可能减少肿瘤复发与转移风险,但其可能降低患者骨密度,增加骨质疏松及骨折的潜在风险,此不良影响应被充分重视。本文分析TSH抑制治疗对骨骼的影响及其机制,建议临床医生综合考虑DTC复发风险、治疗效果及不良反应风险,对患者采取个体化治疗,并监测患者的骨代谢生化指标、骨密度、骨折风险及骨骼影像学。建议采取措施,保护患者的骨骼,包括保持健康生活方式、合理补充钙剂与维生素D,必要时联合使用抗骨质疏松治疗药物等。     

Kinsenoside: A Promising Bioactive Compound from Anoectochilus Species

Kinsenoside is a main active component isolated from plants of the genus Anoectochilus, and exhibits many biological activities and pharmacological effects, including hepatoprotective, anti-hyperglycemic, anti-hyperliposis, anti-inflammatory, vascular protective and anti-osteoporosis effects and so on, which is contributing to its promising potency in disease treatments. This review aims to recapitulate the pharmacological functions of kinsenoside, as well as its source, extraction, identification, quantitative analysis, pharmacokinetics, synthesis and patent information. The data reported in this work can confirm the therapeutic potential of kinsenoside and provide useful information for further new drug development.