普通肝素和低分子肝素对骨代谢的影响

The effect of common heparin and low-molecular-weight heparin on the bone metabolism

普通肝素和低分子肝素常用来预防和治疗老年骨质疏松骨折伴发的下肢深静脉血栓形成。临床研究上证明了在骨代谢的影响方面,低分子肝素要优于普通肝素。普通肝素可能通过多种途径促进破骨细胞的形成,抑制成骨细胞的成骨作用,从而对骨代谢有不良影响。而低分子肝素也能够抑制成骨细胞的作用,但对破骨细胞的作用明显低于普通肝素,总体上造成骨量流失的作用要低于普通肝素,在骨代谢上显示了更好的安全性。肝素类药物对骨代谢的作用可能涉及到了破骨细胞抑制凝集素、护骨素及硬化素等多种途径。

Common heparin and low-molecular-weight heparin （LMWH） often are used to prevent and deal with the low limb deep vein thrombosis which occur in osteoporosis fracture in elder patient. It had been proven that LMWH had more benefit than common heparin in bone metabolism in clinical study. Common heparin can increase osteoclast differentiation and its function by several ways, it also can decrease the function of osteoblast, has the negative effect on the bone metabolism. LMWF also affects the function of osteoblast, but the effect on the osteoclast is lower than common heparin, the effect of decreasing bone mass is lower than common heparin. It shows more benefit than common heparin. The mechanism of so-call heparin-drug maybe involve in osteoclast inhibitory lectin, osteoprotegerin and Sclerostin.