糖皮质激素所致骨质疏松症的临床研究进展

Clinical investigations on glucocorticoid-induced osteoporosis

糖皮质激素所致骨质疏松症（CIDP）是糖皮质激素（GCs）治疗的严重并发症之一。GCs使骨形成减少，骨吸收增加，在GIOP的发生中起关键作用。短期GCs治疗即可出现骨量丢失及骨折危险性增加，因此早期干预十分重要，治疗措施包括钙剂和维生素D制剂、双膦酸盐、激素替代治疗、选择性雌激素受体调节剂、降钙素、重组人甲状旁腺激素（1—34）和维生素K2等。本文从流行病学、临床特点、诊断、预防和药物干预措施几方面作一综述。

Glucocorticoid induced osteoporosis（GIOP） is one of the most severe complications of glucocorticoids（GCs） treatment. GCs can decrease bone formation, increase bone resorption. It directly inhibits the osteoblast＇s function, leads to the decrease of bone formation. Therefore it plays a role in the development of GIOP. Bone loss and the increase of tincture risk can occur after short stage therapy of GCs. Earlier intervention of GIOP is very important. The treatment agents of GIOP include calcium, vitamin D and its analogue, bisphesphonates, hormone replace therapy（HRT）, selective estrogen regulating modulators（SERMs）, calcitonin, parathyroid hormone and vitamin K2. This review introduces the epidemiology, clinical aspect, diagnosis, prevention and treatment of GIOP.