移植骨折的危险因素:一个基于人口的队列研究
Hsin-Lin Tsai1,2, Tzu-Ching Lin2,3, Niang-Cheng Lin2,4
1Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
American journal of nephrology
|October 2, 2023
概括
接受脏移植的人面临更高的骨折风险. 关键的危险因素包括年龄,女性性别,先前的骨折和糖尿病. 尽量减少糖皮质类药物和使用特定的免疫抑制剂可能会减少骨折的发生率.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 整形外科 整形外科 整形外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 接受脏移植的人患骨折的风险较高.
- 针对性预防策略对于这一群体至关重要.
研究的目的:
- 确定台湾脏移植接受者移植后骨折的特定危险因素.
- 为减少骨折的预防策略提供信息.
主要方法:
- 使用国家医疗保险研究数据库进行回顾性队列研究.
- 从2003年至2015年间,对5309名移植接受者的分析.
- 考克斯回归模型用于识别骨折的独立预测因素.
主要成果:
- 移植后骨折发生在10.4%的接受者中.
- 独立预测因素包括65岁以上的年龄,女性性别,先前的骨折,糖尿病和更高的每日普雷迪尼索隆剂量.
- 腹腔透析,高血压,塔克罗利,阿扎西奥普林,甲酸莫菲蒂尔/甲酸,mTOR抑制剂和补充剂的使用与骨折相反相关.
结论:
- 建议最大限度地减少每天的葡萄糖皮质类药物.
- 特定的免疫抑制疗法 (塔克罗利木斯,阿扎西奥普林,甲酸莫菲蒂尔/甲酸,mTOR抑制剂) 和补充剂可能有保护作用.
- 预防策略应针对老年女性,糖尿病患者和有骨折史的人.
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