妊娠哺乳相关骨质疏松症一例并文献复习

妊娠哺乳相关骨质疏松症(pregnancy and lactation-associated osteoporosis, PLO)是一种罕见的骨质疏松,发生在妊娠晚期或哺乳期年轻女性,容易被误诊及漏诊,严重影响妊娠哺乳期妇女身心健康,本文报告一例完整的PLO诊断、治疗以及随访,同时进行相关文献复习。PLO的发病机制目前并不完全清楚,考虑与多途径介导的骨吸收增加和成骨细胞功能障碍有关。治疗上,目前仍然存在争议,可以先停止诱因(妊娠或哺乳),补充基本的钙剂及维生素D,6～12个月再次评估骨密度决定是否进一步应用双膦酸盐等抗骨质疏松治疗。

A case of pregnancy and lactation-related osteoporosis and review of the literature

Pregnancy and lactation-associated osteoporosis (PLO) is a severe and rare type of osteoporosis, which occurs in young women in late pregnancy or lactation, and is easily misdiagnosed and underdiagnosed, seriously affects the physical and mental health of pregnant and lactating women. This paper reports a complete diagnosis, treatment and follow-up of PLO, and reviews relevant literature. The pathogenesis of PLO is not fully understood and is considered to be related to increased bone resorption and osteoblast dysfunction mediated by multiple pathways. It remains controversial whether PLO women should be treated by Anti-osteoporotic drugs such as Bisphosphonates.We can first stop incentive?of pregnancy and breastfeeding,then provide supplement with basic calcium and vitamin D, and re-evaluate bone density at 6-12 months to decide whether to apply further treatment like Bisphosphonates, etc.