药源性骨质疏松的发病原因、致病药物及防治

Drug-induced osteoporosis:mechanisms,causative drug,prevention and treatment

骨质疏松是骨强度受到损害而致骨折风险增加的骨骼疾病,可严重降低患者的生活质量与健康状况。导致药源性骨质疏松的常见药物包括口服抗凝药、钙调磷酸酶抑制剂、强效利尿药、质子泵抑制剂、噻唑烷二酮类降糖药、芳香酶抑制剂、蛋白酶抑制剂、糖皮质激素和抗癫痫药等。致病机制为药物通过促进骨吸收、抑制骨形成、抑制骨矿化影响正常骨代谢。骨密度测定可用于诊断药源性骨质疏松。防治药源性骨质疏松的有效措施包括合理用药,定期监测骨密度,缩短用药疗程,给予患者钙剂、维生素D制剂、双膦酸盐类药物、降钙素、选择性雌激素受体调节剂等药物治疗。

Osteoporosis is a skeletal disorder characterized by compromised bone strength that may predispose to an increased risk of fracture,which can seriously decrease the patient＇ s quality of life and healthy status.The common drugs causing osteoporosis are oral anticoagulants,calcineurin inhibitors,potent diuretics,proton pump inhibitors,thiazolidinediones,aromatase inhibitors,protease inhibitors,glucocorticoids,antiepileptic drugs,etc.The main mechanisms may involve promoting bone resorption,inhibition of bone formation and bone mineralization.Drug-induced osteoporosis is diagnosed by a bone mineral density test.The effective measures for preventing and treating drug-induced osteoporosis include rational drug use,regularly monitoring of bone mineral density,shortening the duration of therapy,and patients should be administered calcium,vitamin D supplementation,bisphosphonate,calcitonin,selective estrogen receptor modulator,and so on.