质子泵抑制剂引发骨质疏松的病变机制和治疗策略

Pathological mechanism and therapeutic strategy of osteoporosis related with proton pump inhibitors

质子泵抑制剂的长期使用会抑制机体对钙的吸收,从而干扰骨代谢、导致骨质疏松或骨折,对老年患者尤其明显。长期使用质子泵抑制剂导致骨折的风险可能与用药剂量和时间相关。目前对预防和治疗质子泵抑制剂引起的骨质疏松主要根据原发性骨质疏松的治疗原则而采取措施,对长期使用质子泵抑制剂的患者应补充钙剂和维生素D以预防骨质疏松,对于已导致的骨质疏松的患者可根据具体病情选择双膦酸盐、降钙素、雌激素和甲状旁腺类似物等治疗。本文对质子泵抑制剂引发骨质疏松的机制及预防和治疗策略的研究进展进行综述。

Long-term use of proton pump inhibitors may interfere with calcium absorption,which will interact with bone metabolism and induce osteoporosis or bone fracture,especially in elderly patients.The fracture risk related with the use of proton pump ihhibitors was associated with dosage and time of duration.The basic principle to prevent drug induced osteoporosis is the same as that for primary osteoporosis.Calcium and vitamin D should be used for prevention.Bisphosphonates,calcitonin,estrogens and PTH can be selected for the treatment of osteoporosis or fracture induced by proton pump inhibitors according to the individual condition of patients.In this paper,we review the advance on pathological mechanism and therapeutic strategy of osteoporosis induced by proton pump inhibitors.