骨质疏松症课件.ppt

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,按一下以編輯母片標題樣式,按一下以編輯母片,第二層,第三層,第四層,第五層,骨質疏鬆症,骨質疏鬆症的危險因子,缺乏運動,鈣質攝取不足,體型瘦小,長期使用類固醇藥物,抽煙酗酒,雌激素缺乏,本人曾發生骨折,日曬不足,家族老人曾發生骨折,Bone modeling and remodeling,Bone modeling,Child and adolescent,Non-coupling:bone formation and resorption occur on separate surfaces,Bone remodeling,The replacement of old bone tissue by new bone tissue in the adult skeleton,Coupling,Osteoporosis,imbalance in bone remodeling,Results in thinning,and eventual,loss of,trabecular,connectivity,Normal bone,Osteoporosis is defined as a skeletal disorder characterized by,compromised bone strength,predisposing a person to an increased risk of fracture.Bone strength primarily reflects the integration of,bone density,and,bone quality,.,NIH Consensus Conference,Definition of Osteoporosis,NIH Consensus Development Panel on Osteoporosis.JAMA 285:785-95,2001,Osteoporosis,Osteoporosis,Primary osteoporosis,Older persons and women past menopause in which bone loss is accelerated over that predicted for age and sex.,Secondary osteoporosis,Metabolic bone disease,hyperparathyroidism,Neoplasia,multiple myeloma or metastatic carcinoma,Malnutrition,Drug therapy,with corticosteroids,Prolonged immobilization,Weightlessness with space travel,Primary prevention,Should provided all the people as comprehensive measures against other lifestyle-related diseases,Secondary prevention,Should target people at higher risk of osteoporotic fractures,Tertiary prevention,Should be provided the patients and at frail elderly people using medical or long-term care insurance,Osteoporosis Tutorial,超音波,雙能量,X,光骨密度檢查,Factors affecting bone metabolism,Medical treatment for osteoporosis,Anti-,resorptive,agent,Estrogen,SERM,Raloxifene,(,Evista,),Calcitonin,Bisphosphonate,Alendronate,(,Fosamax,),Risedronate,(,Actonel,),Ibandronate,(,Bonviva,),(,Bone,resorption,),Anabolic agent,PTH(cyclic use),(,Bone formation),Strontium,ranelate,(,Bone formation),(Bone,resorption,),OPG,Protos,NEJM,2004;350:459-468,16,AEs,of strontium,ranelate,(,Protos,),Gastritis,3.6,5.5,0.066,Gastric ulcer,1.0,1.1,NS,Esophagitis,0.8,0.6,NS,Symptoms(%),Diarrhea,6.1,3.6,0.019,p,Placebo,PROTOS,2g of,strontuim,ranelate,mix with a glass of water and drink immediately.,Taken before bedtime or 2-h before/after the meals,Thank you for your attention!,。