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尿脱氧吡啶啉排泄率评价绝经后妇女骨质疏松症的疗效
尿脱氧吡啶啉(DPD)是I型胶原纤维的降解产物,释放入血并从尿中排出,不受饮食影响,是反映骨吸收的一个特异指标[1].而骨吸收造成的骨丢失是妇女发生骨质疏松的主要因素,本研究通过对56例绝经后骨质疏松症患者行鲑鱼降钙素治疗前、治疗3个月及6个月尿DPD排泄率及骨密度(BMD)等相关指标的检测,以评价骨质疏松症的治疗效果.
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回眸到静思——如何理性地看待绝经后妇女的激素治疗
2002年WHI(Women's Health Initiative,妇女健康启动)的研究报告,无疑为全世界的HT(Hormone Therapy,激素治疗)扔下了一颗重磅炸弹.该研究结果显示,每日倍美力0.625 mg加安宫黄体酮2.5 mg,连续应用5.2年后,与安慰剂相比,卒中增加41%,心脏病发作增加29%,静脉血栓形成率加倍,总的心血管疾病增加22%,乳腺癌增加26%,髋关节骨折减少1/3,总的骨折减少24%,结直肠癌发生率减少37%,总死亡率无差异.此后,人们对HT议论纷纷.随着对WHI的深入分析以及其他HT研究的开展,目前医学界对HT的认识更加理性、更加深入,HT的研究和临床使用进入了新的时期.
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Osteoporosis and consequent fracture are not limited to postmenopausal women. There is increasing attention being paid to osteoporosis in older men. Men suffer osteoporotic fractures about 10 years later in life than women, but life expectancy is increasing faster in men than women. Thus, men are living long enough to fracture, and when they do the consequences are greater than in women, with men having about twice the 1-year fatality rate after hip fracture, compared to women. Men at high risk for fracture include those men who have already had a fragility fracture, men on oral glucocorticoids or those men being treated for prostate cancer with androgen deprivation therapy. Beyond these high risk men, there are many other risk factors and secondary causes of osteoporosis in men. Evaluation includes careful history and physical examination to reveal potential secondary causes, including many medications, a short list of laboratory tests, and bone mineral density testing by dual energy X-ray absorptiometry (DXA) of spine and hip. Recently, international organizations have advocated a single normative database for interpreting DXA testing in men and women. The consequences of this change need to be determined. There are several choices of therapy for osteoporosis in men, with most fracture reduction estimation based on studies in women.