关注抗骨质疏松药相关甲状旁腺功能增强或亢进的防治  

Prevention and treatment of anti-osteoporosis drugs related parathyroid hyperfunction or hyperparathyroidism

作　　者：孔令泉[1] 母力元 吴凯南[1] Kong Lingquan;Mu Liyuan;Wu Kainan(Department of Breast and Thyroid Surgery,the First Afiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院乳腺甲状腺外科,重庆400016

出　　处：《中华内分泌外科杂志》2023年第4期385-389,共5页Chinese Journal of Endocrine Surgery

摘　　要：骨质疏松症是一种常见的增龄性疾病,已成为我国面临的重要公共健康问题。抗骨质疏松药是治疗骨质疏松症的重要手段,但部分患者使用抗骨质疏松药后疗效不佳,可能与抗骨质疏松药相关甲状旁腺功能增强或亢进相关。作为高钙危象的抢救用药,抗骨质疏松药应用后使血钙明显下降。在目前推荐剂量下补充维生素D和钙剂,使用抗骨质疏松药的部分骨质疏松患者中可出现血钙降低及负钙平衡,刺激甲状旁腺增生、肿大,致甲状旁腺功能增强或亢进。使用抗骨质疏松药期间,在密切监测血钙、甲状旁腺素(parathyroid hormone,PTH)及相关骨代谢指标的基础上补充足量维生素D和钙剂有利于维持血钙和PTH稳定,防治抗骨质疏松药相关甲状旁腺功能增强或亢进,进而有效防治骨量流失、骨折、身高变矮、驼背、全身骨关节肌肉疼痛、转移性血管钙化及全身钙质沉着症等疾病,提高抗骨质疏松药疗效,减少不良反应,全面改善骨质疏松患者预后,提高人民健康水平.Osteoporosis is a common age-related disease which has become a severe public health prob-lem in China.Anti-osteoporosis drug is important to treat osteoporosis,but some patients have poor efficacy after us-ing anti-osteoporosis drugs,which may be associated with anti-osteoporosis drugs related parathyroid hyperfunction or hyperparathyroidism.As a emergency drug for hypercalcemia crisis,anti-osteoporosis drug can cause a signifi-cant decrease in serum calcium.With the current recommended doses of vitamin D and calcium supplementation,some patients presented with a decreased level of serum calcium and negative calcium balance after receiving anti-osteoporosis drugs,stimulating parathyroid hyperplasia and enlargement,leading to parathyroid hyperfunction or hyperparathyroidism.During the treatment of anti-osteoporosis drugs,sufficient vitamin D and calcium supplemen-tation on the basis of closely monitoring of serum calcium,parathyroid hormone(PTH)and related bone metabo-lism indicators is beneficial to maintain the stability of serum calcium and PTH,preventing anti-osteoporosis drugs related parathyroid hyperfunction or hyperparathyroidism.Furthermore,it can efficiently prevent and treat bone loss,fractures,height shortening,hunchback,systemic musculoskeletal and joints pain,metastatic vascular calcifi-cation and calcinosis universalis,improve the efficacy of anti-osteoporosis drugs,reduce adverse reactions,compre-hensively improve the prognosis of osteoporosis patients,and protect people's health.

关 键 词：骨质疏松症 抗骨质疏松药 负钙平衡 甲状旁腺功能增强或亢进 抗骨质疏松药相关甲状旁腺功能增强或亢进 

分 类 号：R580[医药卫生—内分泌] R581[医药卫生—内科学]