骨质疏松症（ OSTEOPOROSIS， OP）是一种以骨量低下、骨微结构损坏而导致骨脆性增加、易发生骨折为特征的全身性骨病。骨质疏松症所致的骨折严重影响患者的健康和生活质量，并对社会经济造成沉重的负担。目前骨质疏松症的治疗手段主要是以双膦酸盐类为主的抗骨吸收类药物。这类药物抑制骨吸收，但无法新生成骨组织。以重组人甲状旁腺素（1－34）[PTH（1－34）]为代表的促骨形成类药物作用于成骨细胞，通过刺激骨形成发挥作用，为治疗骨质疏松症提供了新的选择。多项临床研究证明PTH（1－34）可增加骨密度并改善骨结构，长期应用可降低骨质疏松症患者椎体和非椎体骨折发生率。 PTH （1－34）已在中国获批用于治疗有骨折高发风险的绝经后妇女骨质疏松症。骨质疏松症不仅增加了患者发生骨折的风险，也使得骨折愈合更加困难。由于PTH（1－34）特殊的成骨作用机制，近年来其在治疗骨折不愈合和脊柱融合等骨科领域的应用也日益受到重视，并且已经有一些成功的个案报道。本文回顾了近年来国内外关于PTH（1－34）在骨质疏松症和骨科领域的临床研究的进展，以期为临床实践提供参考。%Osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to an enhanced bone fragility and a consequent increase in fracture risk.The fracture caused by osteoporosis seriously impacts on the health and life quality of patients and causes heavy burden to social economy.Nowadays, the major therapy for osteoporosis is antiresorptive treatment, of which bisphosphonates are representative.Bisphosphonates inhibit bone resorption.However, they can not increase bone formation.Anabolic therapies that are represented by recombinant human parathyroid hormone (1-34) ( PTH[1-34]) act on osteoblasts and stimulate bone formation, and thus provide a different choice for osteoporosis treatment.Multiple clinical studies have shown that teriparatide is able to increase bone mineral density and to improve bone structure, and its long-term application can reduce the incidence of vertebral and non-vertebral fracture in patients with osteoporosis.PTH ( 1-34 ) has been approved in China to treat postmenopausal women with osteoporosis at high risk for fracture.Osteoporosis not only increases the risk of fractures but also makes fracture healing more difficult.Given the specific mechanism of action of PTH ( 1-34 ) on bone formation, increased attention has also been paid to its application in the orthopedics field, such as fracture healing and spinal fusion, and there have been some case reports in this field.This review summarizes the recent progresses in clinical studies of PTH (1-34) in osteoporosis and orthopedics field, which may be used as a reference for clinical practice.
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