ign骨质疏松的管理与脆性骨折的预防

《ign骨质疏松的管理与脆性骨折的预防》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、Managementofosteoporosisandthepreventionoffragilityfractures骨质疏松的管理与脆性骨折的预防ScottishIntercollegiateGuidelinesNetwork苏格兰校际指南网LEVELSOFEVIDENCE1++Highqualitymeta-analyses,systematicreviewsofRCTs,orRCTswithaverylowriskofbias1+Wellconductedmeta-analyses,systematicreviews,orRCTswithalowriskofbias1-Me

2、ta-analyses,systematicreviews,orRCTswithahighriskofbias2++HighqualitysystematicreviewsofcasecontrolorcohortstudiesHighqualitycasecontrolorcohortstudieswithaverylowriskofconfoundingorbiasandahighprobabilitythattherelationshipiscausal2+Wellconductedcasecontrolorcohortstudieswithalowriskofconfound

3、ingorbiasandamoderateprobabilitythattherelationshipiscausal2-Casecontrolorcohortstudieswithahighriskofconfoundingorbiasandasignificantriskthattherelationshipisnotcausal3Non-analyticstudies,egcasereports,caseseries4ExpertopinionTheneedforaguidelineIn2012,fracturesoccurredin19.8outof1,000womenand

4、8.4outof1,000menovertheageof50inScotland.Themajorityoffracturesoccurinpeopleovertheageof65andalargeproportionofthesepatientshaveosteoporosis.Fracturesareanimportantcauseofmorbidity,andpatientswhosufferhipfractures髋部骨折andvertebralfractures椎体骨折haveadecreasedlifeexpectancycomparedwithpopulation-ba

5、sedcontrols.2Keyrecommendations2.1riskfactorsPeoplewithahistoryoffragilityfracturesovertheageof50shouldbeofferedDXAscanningtoevaluatetheneedforantiosteoporosistherapy.2Keyrecommendations2.2quantifyingtheriskoffractureFracture-riskassessmentshouldbecarriedout,preferablyusingQFracture,priortoDXAi

6、npatientswithclinicalriskfactorsforosteoporosisandinwhomantiosteoporosistreatmentisbeingconsidered.MeasurementofbonemineraldensitybyDXAatthespineandhipshouldbecarriedoutfollowingfracture-riskassessmentinpatientsinwhomantiosteoporosistreatmentisbeingconsidered.2Keyrecommendations2.3managementofo

7、steoporosisinpostmenopausalwomenRepeatBMDmeasurementsbyDXAafteranintervalofthreeyearsmaybeconsideredtoassessresponsetotreatmentinpostmenopausalwomenonalendronicacid阿仑膦酸,ibandronicacid伊班膦酸,zolendronicacid唑来磷酸ordenosumab狄诺塞麦therapy.