How to manage osteoporosis in children
How to manage osteoporosis in children
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DOI：
10.1016/j.berh.2005.06.006
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发表时间：
2005-12-01
影响因子：
5.2
通讯作者：
Bianchi, ML
中科院分区：
文献类型：
--
作者：
Bianchi, ML
骨质疏松症越来越多地出现在年轻人中。原始形式相对罕见，但继发性形式--特别是在长期皮质类固醇治疗中--是一个相关的问题，因为囊性纤维化、慢性肾功能不全、白血病和Duchenne肌营养不良等慢性疾病的存活率要长得多。评估儿童预防和治疗效果的前瞻性对照研究仍然缺乏。治疗的基础是每天正确的钙摄入量和维生素D(或活性代谢物)的使用。在许多情况下，这有助于成长中的骨骼恢复平衡。将皮质类固醇的长期使用限制在最低有效剂量和较短的持续时间是至关重要的。在严重的情况下，特别是在骨折的情况下，双膦酸盐可以非常有效。在某些情况下，如特发性青少年骨质疏松症，规则是自发解决，并讨论了积极的药物治疗的建议。
Osteoporosis is increasingly being seen in young people. The primitive forms are relatively rare, but the secondary forms-particularly in long-term corticosteroid therapy-are a relevant problem given the much longer survival in chronic diseases such as cystic fibrosis, chronic renal insufficiency, leukaemia, and Duchenne muscular dystrophy. Controlled, prospective studies to evaluate the results of prevention and therapy in children are still lacking. The basis of therapy is the correct daily intake of calcium and the use of vitamin D (or active metabolites). This helps the growing skeleton to restore its equilibrium in many cases. Restraining the long-term use of corticosteroids to the minimum effective dose and shorter duration is essential. In severe cases, particularly in the presence of fractures, bisphosphonates can be remarkably effective. In some cases, such as idiopathic juvenile osteoporosis, the rule is spontaneous resolution, and the advisability of an aggressive drug therapy is discussed.