钙制剂治疗原发性骨质疏松症的重要性

1、钙制剂治疗原发性骨质疏松症的重要性good doctor continuing medical education centeryour location: home page > my continuing educationosteoporosis treatment strategythe importanee of calcium in the treatment of primary osteoporosisdepartment of orthopedics, beijing friendship hospital affiliated to capital medical u

2、niversity, hu zhenming, luo xianzhengcalcium deficiency is one of the five leading causes of primary osteoporosisthe age of calcium treatment for osteoporosis began in the 1960s,nordin according to a large number of animal experiments and clinical studies, it is suggested that calcium deficiency is

3、the etiological factor of primary osteoporosis matkovic supports calcium deficiency from epidemiological studies, which can lead to osteoporosis however, the role of calcium deficiency in the pathogenesis of osteoporosis has been debated since pommer was proposed in the mid nineteenth century and cl

4、early separated from osteomalacia,in a large number of studies, scholars in various countries have not only further understood how estrogen deficiency and calcium deficiency cause primary osteoporosis, but also found many important new etiological theories the pathogenesis of these theoretical findi

5、ngs further clarify the primary osteoporosis, but also brings about a breakthrough for the prevention and treatment of primary osteoporosis, calcium deficiency is considered to be one of the five primary causes of the pathogenesis of osteoporosis the study found that calcium is absorbed by the human

6、 body into the blood, the blood and the part of the calcium to form calcium in bone tissue, when the body of calcium, in order to maintain the concentration of calcium in the blood, but will be within the bones of calcium mobilization, re dissolved into the blood, leading to osteoporosis at present

7、there is that postmenopausal osteoporosis etiology is estrogen deficiency leads to increased bone resorption and decreased intestinal calcium absorption, secondary to estrogen deficiency induced by calcium induced negative balance point of view, there are also holding a calcium deficiency is osteopo

8、rosis reason and one reason view, but many scholars have stressed the common proper perturbation significantly the consequences of calcium in the treatment of osteoporosis or inadequate calcium intaketwo, how calcium supplements in the treatment of osteoporosis? what are the precautions in calcium s

9、upplementation?the importance of calcium and osteoporosis, the consensus is calcium is a kind of main minerals in the bones, is a prerequisite for normal bone growth, bone mass during adolescence can promote the development of the elderly can delay the postmenopausal osteoporosis; calcium is a basis

10、 for the treatment of osteoporosis, especially in postmenopausal women, such as the occurrence of hip fracture, the overall calcium loss of up to 50%, so the elderly usually should be sufficient intake of dietary calcium. however, high calcium intake is not an alternative to estrogen therapy for est

11、rogen deficiency, and patients with more severe osteoporosis may not be treated with calcium aloneprevention of osteoporosis is more important than treatmentthe purpose of osteoporosis treatment is to relieve bone pain, increase bone mass and reduce the incidence of fracture because the osteoporotic

12、 fracture seriously affects the physical and mental health of the elderly, and causes huge medical expenses, it is the most important and final goal to reduce the incidence of fracture in the treatment most of the drugs for the treatment of osteoporosis are bone suppression drugs, which inhibit bone

13、 resorption by reducing the production of osteoclasts or reducing the activity of osteoclasts, thus preventing excessive loss of bone mass currently, there is a lack of bone morphogenetic drugs that stimulate osteoblast activity, and bone resorption inhibitors may be used in severely osteoporotic pa

14、tients with rapid bone loss the use of such drugs in patients with slow bone loss is beneficial to preserve the integrity of trabecular bone structure so far, interventions have been able to repair tiny, small, liang zengcu bones and small perforations,it is not possible to connect the fractured tra

15、becular bone, so prevention is more realistic and important than treatment. eating calcium rich foods, adequate calcium intake and appropriate amount of illumination are basic and supplementary measures what about the effect of simple calcium supplementation on bone mineral density?black et al. (200

16、0) synthesized 15 randomized controlled trials of calcium alone in 1806 postmenopausal women, 953 were treated with calcium alone for 2 yearsfor simple supplementation of calcium, there is a slight in crease in the role of bmd chapuy et al (1994) reported taking calcium 1200 mg and vitamin d 800 iut

17、he incidence of hip fractures and non vertebral fractures was reduced by 27% and 28%, respectively, over 3 yearsa large number of animal and human experimental studies have proved that if the subjects are normal in calcium nutrition, the absorption rate is generally 40%, and if the nutritional statu

18、s of calcium is poor, then the absorption rate may reach 75 85% none of the calcium preparations had a particularly high absorption rate in fact, what we need is calcium supplementation, which is the calcium in various calcium preparations, not the preparation itself. the preparation itself is only

19、used as the carrier of calcium therefore, the choice of calcium preparations, first of all depends on the percentage of calcium in the preparation in general, the calcium threshold is 1000 1500mg, calcium intake is more, the calcium threshold will not rise, so it will not deposit more calcium the ma

20、in influencing factors of calcium absorption were calcium 1, 25- (oh) 2d3 this is the vitamin d in food and human skin in the 7-， dehydrogenation of cholesterol by sunlight after the synthesis of vitamin d3, and then in the liver, especially in the kidney by hydroxylation reaction generated it can p

21、romote the absorption of calcium in the small in testi ne and even in the col on. if the body lacks 1, 25- (oh) 2d3, the absorption of calcium is only 10% if vitamin d is added and 1 and 25- (oh) 2d3 are synthesized in the liver and kidneys, the calcium absorption rate increases to 60 to 75% thus, t

22、he promotion of calcium absorption, the different types of calcium preparations are secondary, the main body or 1, 25- (oh) 2d3 content is abundant the homes of the elderly, patients with renal disease, due to the lack of 1, 25- (oh) 2d3, is very easy to cause calcium malabsorption and deficiency, a

23、nd the incidence of fractures the lack of estrogen can affect the absorption and deficiency of calcium in postmenopausal women. in addition, growth hormone and parathyroid hormone deficiency also affect calcium absorption. increase bone density, prevent osteoporosis, on the one hand need to add calc

24、ium, etc，on the other hand, must be in the weight-bearing state to make calcium effectively absorbed in bone tissue calcium combined with proper weight-bearing exercise, exercise can cause the increase of bone mass, is the most effective method to prevent osteoporosis, even long-term bedridden elder

25、ly, should as far as possible every 1 hours from the bed, and the bone weight bearing load, the more muscle contraction, which are useful to postpone or delay the process of osteoporosis menopausal women exercise 3 hours a week, can make the overall amount of calcium increased, bone and muscle weigh

26、t exercise can obtain ideal effect, including walking, jogging and standing exercise, and in sufficient amount of calcium.primary osteoporosis is a common disease in the elderly. it is a systemic bone disease mainly because of low bone mass and destruction of the fine structure of bone, resulting in

27、 increased fragility of bone and prone to fracture the mineral and bone matrix of bone tissue decreased primary osteoporosis is divided into postmenopausal osteoporosis (i) and senile osteoporosis (type ii) and idiopathic osteoporosis (including juvenile); postmenopausal osteoporosis generally occur

28、s in 5-10 in postmenopausal women,osteoporosis in the elderly generally refers to osteoporosis after 70 years of age,and idiopathic osteoporosis mainly occurs in adolescents, the cause is unknown. primary osteoporosis is more common in women than in men, and is common in postmenopausal women and the

29、 elderly,fractures are common in patients with minor trauma or trauma, especially in women over the age of 75. the fracture rate is higher than 80% the research confirmed that the pathogenesis of primary osteoporosis is (1), senilehuman hormone secretion decreased is one of the important reasons; (2

30、) with the increase of age, secretion of calcium regulating hormones in bone metabolism the renal function of the elderly decreased significantly, the rate of creatinine clearance decreased, resulting in elevated blood phosphorus, secondary rise in pth, increased bone absorption, bone calcium decrea

31、sed the activity of 1 alpha hydroxylase decreased in the elderly, resulting in decreased synthesis of 1, 25 (oh) 2d3, decreased intestinal calcium absorption, and increased secretion of feedback pth the function of the elderly c cells" recession, reduce the secretion of ct, bone formation decre

32、ased; (3) theelderly due to tooth loss and reduce digestive function, eating less, there are many nutritional deficiencies, resulting in protein, calcium, phosphorus, vitamins and trace elementsthe serum phosphorus content was negatively correlated with age, and the ratiointake. insufficient or exce

33、ssive protein intake can negatively regulate calcium balance and bone calcium content.phosphorus in osteogenesis carboxylationof ca/p increased with the decrease of serum the elderly, resulting in the reduction of vitamin k deficiency can affect the of osteocalcin, higher uncarboxylated osteocalcin,

34、 can accelerate bone loss, prone to cause fracture;(4) with the increase of age, reduce outdoor sports is also an important reason for the elderly osteoporosis. outdoor sports and sunshine reduced vitamin d synthesis decreased, the elderly over the age of 60 in the blood of 25 (oh) 2d3 was decreased

35、 by 30% than the 20 year old young people, vitamin d feed can make the intestinal absorption of calcium and phosphorus decreased, and the bone mineralization of bone formation decreased. (5) osteoporosis is closely related to the variation of vitamin d receptor gene. the decrease of transforming gro

36、wth factor beta (tgf-) in bone matrix is probably the cause of the decrease of bone formation ability.so far, the treatment of osteoporosis has emphasized the etiology, treatment, comprehensive treatment and prevention. primary type i osteoporosis is a metabolic type, which is due to the decrease of

37、 estrogen in postmenopausal women and the loss of bone mass caused by bone resorption. therefore, bone resorption inhibitors such as estrogen, calcitonin and calcium preparations should be used ii type of primary osteoporosis, the cause is due to the aging caused by the imbalance of hormones regulat

38、ing bone formation is low, the application of bone formation enhancers, such as vitamin d, anabolic steroids (nandrolone), calcium and vitamin k2. therefore, calcium is one of the important measures for the treatment and prevention of osteoporosis, whether it is the cause or the pathogenesis of prim

39、ary osteoporosis but high calcium intake can not replace estrogen deficiency due to estrogen replacement therapy, calcium supplements alone will not necessarily have a good effect, it should be under the guidance of doctors for treatment. however, there is no effective and safe method to restore the

40、 loose bone tissue to norma1. therefore, in the treatment of primary osteoporosis at the same time, prevention can reduce postmenopausal and accompanied by aging and bone loss, prevention is very importantthere are two methods for calcium supplementation in patients with osteoporosis: dietary calciu

41、m supplementation and calcium supplementation. dietary calcium supplementation refers to the rational and adequate intake of calcium from food it is one of the effective ways to prevent and treat osteoporosis most experts believe that the safest and effective way to supplement calcium is to increase

42、 calcium intake in the daily diet, and calcium supplements are safer than calcium supplements, which do not cause excessive calcium levels milk and dairy products are rich in calcium, not only on the development of children, adults and the elderly are necessities, green leafy vegetables, beans and bean products, seafood such as seaweed, seaweed calcium is high quality commonly used drugs, calcium preparations are divided into inorganic calcium and organic calcium two categories, inorg