补充钙剂对绝经后妇女骨质疏松的预防作用

Calcium Supplementation and Postmenopausal Osteoporosis.

目的探讨补充钙剂对预防绝经后妇女骨质疏松的有效性和安全性。方法用回顾性分析法分析1992年12月至2007年9月文献关于补充钙剂及钙剂联合其他药物应用对绝经后妇女骨质疏松预防的高质量研究报道,分析其所用方法、质量和效果。结果单纯补充钙剂对预防45~70岁白色及黄色人种妇女的骨质疏松有效,但钙剂联合雌激素和(或)孕激素、维生素D3、降钙素等较单用钙剂对预防骨质疏松效果更好。每日摄入800 mg钙剂,并不影响人体对锌或铁的吸收,也不会导致高尿钙症;而不同时间补充钙剂,可能会影响胃、肠对钙及草酸盐的吸收,从而增加肾结石发生风险;合理饮食、均衡蛋白质及盐类摄入,可有效预防骨密度降低;绝经后妇女应尽早开始多摄入富含钙食物,并根据年龄、胃酸分泌是否不足及对钙剂的个体反应,选用恰当钙剂。结论补充钙剂可预防绝经后妇女骨密度降低及钙丢失,防止骨质疏松的发生。口服钙剂应在餐后1.0 h^1.5 h。理想的钙剂应为含钙量高、体内易溶解、接近中性、安全无毒、生物利用度高、价廉,建议使用碳酸钙。

Objective To discuss the effectiveness of calcium supplements for the prevention of osteoporosis in postmenopausal women. Methods The lectures of calcium supplementation for the prevention of osteoporosis in 45 to 70-year-old women from December 1992 to September 2007 were included and analyzed retrospectively. Results Calcium could prevent the osteoporosis, on the other hand, the effectiveness of supplementation of calcium plus estrogen and （or） progesterone, vitamin D3, caleitonin are much better than using calcium only. Calcium intake（800 mg/d） will not reduce the absorption of zinc or ferrum, not break the balance in body, and will not result in hypercalcinemia. Variation in the time of calcium supplement may affect gastrointestinal absorption of both calcium and oxalate and may associate with variable risk of calcium oxalate nephrolithiasis. Postmenopausal women should take in high-calcium food as early as possible, choose proper calcium supplements according to their age. The content of hydrochloric acid in gastric juice and the reaction of different calcium supplements. Conclusion Calcium supplements, rational diet, balanced intake of protein and salt can prevent the loss of bone mineral density. Bone mineral content could reduce the risk of osteoporosis in postmenopausal women. It is better for them to take the oral calcium supplements between one to one and half an hour after meal. The ideal calcium supplements should be rich in calcium, safe, nonpoisonous, approaching neutrality, easy to be absorbed and proper price. Moreover, calcium carbonate is recommended.