炎症性肠道疾病患者的骨健康
Andrea S Kreienbuehl1, Gerhard Rogler1, Burri Emanuel2
1Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Swiss medical weekly
|June 14, 2024
概括
患有炎症性肠病 (IBD) 的患者经历了骨密度降低和骨折风险增加. 早期查和向治疗,如双酸盐,对于管理IBD相关的骨损失至关重要.
科学领域:
- 胃肠道学和内分泌学
- 骨代谢和骨质疏松症研究研究
背景情况:
- 炎症性肠病 (IBD) 患者经常出现骨密度下降和骨折率更高的情况.
- 骨质疏松症影响高达40%的IBD患者,受疾病活动,药物副作用和并发症的影响.
- 低诊断和多样化的管理实践有助于IBD的持续性骨健康问题.
研究的目的:
- 审查IBD患者骨损失的病理生理学,诊断,预防和治疗.
- 突出导致IBD患者骨质疏松症的关键因素.
- 概述目前IBD相关骨病的查指南和治疗选择.
主要方法:
- 审查有关IBD和骨代谢的现有文献.
- 分析病理生理因素,包括营养不良,炎症和皮质类固醇使用.
- 检查诊断工具,如双能X射线吸收度 (DXA) 和风险评估得分 (FRAX).
主要成果:
- 营养不良,慢性炎症和皮质类固醇使用是IBD骨质疏松症的主要驱动因素.
- 对于长期患有IBD,重复使用类固醇或具有特定风险因素的IBD患者,建议进行DXA查.
- 有效的治疗方法包括疾病控制,维生素D,糖皮质激素节约策略,双酸盐,RANKL抑制剂,PTH类似物和SERM.
结论:
- 与IBD相关的骨损失是一个重要的临床问题,需要主动管理.
- 综合性查和量身定制的治疗策略对于改善IBD患者骨健康结果至关重要.
- 需要采取多方面的方法来应对疾病活动和特定的骨保护剂.
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