骨质疏松性骨折的临床挑战和对策.pptVIP

临床研究指导临床实践阿仑膦酸钠可以长期控制骨折危险 Weinstein et al, ASBMR, 2001. “虽然存在微损伤的积累，但研究依旧表明大剂量双膦酸盐抑制骨代谢的同时伴随着骨强度的提高。” (Bone 28:524-531, 2001) 双膦酸盐对抑制骨代谢引起微损伤的累积和生化性质的影响的犬类研究 T. Mashiba, C.H. Turner, T. Hirano, M.R. Forwood, C.C.Johnston, and D.B. Burr 学术争论的回答 双膦酸盐是否会过多降低骨代谢，并有可能损害骨强度？ 结论：目前没有证据说明福善美会过度抑制骨代谢并损害骨强度 结论－1 骨质疏松已成为全球性问题；它的危害性在于发生骨折以及对骨科临床的影响 大多数骨质疏松患者没有得到正确的诊断与治疗 骨强度的降低是导致骨质疏松病人出现骨折主要因素 结论－2 就临床实践而言，骨密度是骨强度和骨折危险性的主要决定因素 福善美对于骨密度、骨强度和骨折的突出疗效已被广泛和长期的研究所证实 谢 谢 ！ * Slide 3 骨质疏松一般可分为原发性骨质疏松和继发性骨质疏松。原发性骨质疏松根据病因不同，又可分为绝经后骨质疏松和老年性骨质疏松。继发性骨质疏松主要由各种疾病和药物引起。 * Slide 3. Understanding Hip Fractures * Slide 4. Assessing the Economic Toll Based on a study of individuals aged 45 years and older conducted by the National Osteoporosis Foundation, total expenditures attributable to osteoporotic fractures in 1995 were estimated at $13.76 billion.5 Total costs of treatment for osteoporotic hip fractures were estimated to be $8.68 billion; the greatest proportion of expenditures was for inpatient hospital and nursing home services.5 Other services included in the total expenditures were emergency room, outpatient physician, outpatient hospital, home health care, ambulance services, and medical equipment.5 * The pull-out force of screws in porotic bones is strongly reduced. * Osteoporosis is the most common disease of bone in humans. It is a systemic skeletal disease, characterized by low bone mass and by microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Dempster DW, Shane E, Horbert W, et al. A simple method for correlative light and scanning electron microscopy in human iliac crest bone biopsies: qualitative observations in normal and osteoporotic subjects. J Bone Miner Res 1986;1:15-21. Consensus Development Conference. Diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 1993;94:646-50. . * 1. Curry JD 1986 Power law models for the mechanical