抗凝药物相关骨质疏松症

Anticoagulant drugs and osteoporosis

抗凝药物的长期应用已被发现与骨质疏松症相关。维生素K拮抗剂、直接凝血酶抑制剂、间接凝血酶抑制剂均是临床抗凝治疗的常用药物。大量临床研究报道了抗凝药物所致骨量减少,严重时可并发骨质疏松性骨折。这些药物可通过不同的药理机制干扰骨转换,使骨丢失大于新骨形成。其中,新型口服抗凝药、低分子肝素和磺达肝癸钠对骨转换影响较小,显示了更好的安全性。本文主要讨论临床常见抗凝制剂致骨质疏松风险及相关机制研究进展。

Long-term use of anticoagulant drugs are indicated to be correlated with an increased risk o｜＂ osteoporo- sis. Vitamin K antagonists and direct/indirect thrombin inhibitors are listed in popularity for treatment and thromboprophylaxis. Cumulative clinical outcomes reported that bone loss with fractures also occurs in severe cases. These drugs may affeet bone turnover and result in bone loss far exceeding the bone formation. New oral anticoagulant drugs, low molecular weight heparin and fondaparinux are novel therapeutic options due to rare side effects on bone health. In the present paper, we reviewed the association between anticoagulant drugs and osteoporosis, as well as its underlying possible mechanisms.