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2009亚洲骨质疏松大会

2009亚洲骨质疏松大会

  • 召开年:2009
  • 召开地:北京
  • 出版时间: 2009-09-26

主办单位:中国健康促进基金会

会议文集:2009亚洲骨质疏松大会论文集

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  • 摘要:目的:分析双能X线骨密度仪(dual-energy X-rayabsorptiometry,DXA)测量骨密度的最小有意义变化(leastsignificant change,LSC)。rn 方法:测量30名受检者腰椎和髋部BMD,连续测量2次,计算其精确度误差、最小有意义变化,预计随访间隔时间。rn 结果: L1-L4、L2-L4、左全髋部、右全髋部的精确度误差相对较低,标准差的均方根(RMS-SD)分别为0.006、0.007、0.006、0.007g/cm2,最小有意义变化(LSC-SD)分别为0.016、0.018、0.018、0.019g/cm2;变异系数的均方根(RMS-CV)分别为0.005、0.007、0.006、0.007,最小有意义变化(LSC-CV)分别为0.015、0.020、0.018、0.020。LSC-SD、LSC-CV的变异系数分别为0.238、0.356。预计随访间隔时间随着感兴趣区精确度误差的增加而延长。rn 结论:DXA测量骨密度的精确度误差较小,感兴趣区首选L1-L4、L2-L4、全髋部为宜,感兴趣区的精确度误差越大则预计随访时间越长。
  • 摘要:Background and Objective:Our previous study showed angiotensin converting enzyme (ACE) inhibitor use was associated with higher bone mineral density (BMD) in elderly people, especially male subjects, which suggested that ACE inhibitors may have a protective effect on age-related bone loss. In this study, we set to examine the independent effect of ACE inhibitor on bone loss in elder Chinese.rn Methods:The subjects were come from two cohort studies, which set to investigate the risk factors of osteoporotic fractures in Hong Kong-dwelled elder Chinese. The subjects had a baseline interview and were followed up every two years for four years. Current smokers and those who took osteoporosis related medications and angiotensin Ⅱ type Ⅰ receptor blockers at either visit were excluded. Totally, 2161 subjects (1280 male and 881 female) were selected for this analysis. The ACE inhibitor users were compared with non-users using ANOVA test for continuous variables or chi-square test for categorical variables. Univariate analysis was performed to examine the associations between annualized percentage bone loss at total hip and some potential confounders. Those confounders which showed significant associations at P < 0.1 were included in the final multiple regression model as covariates to examine the independent effect of ACE inhibitor on bone loss at total hip and femoral neck.rn Results:Unadjusted annualized percentage bone loss of male ACE inhibitor users were not different from non-users,however, female ACE inhibitor users had significantly greater bone loss both in total hip and femoral neck than non-users.Univariate analysis showed age, baseline body weight, annualized percentage weight change, baseline total hip BMD,history of diabetes and hypertension, steroid use, calcium supplement, thiazide diuretics use, loop diuretics use,beta-blocker use and calcium antagonist use were significantly associated with annualized percentage bone loss of total hip at P < 0.1 level. After adjusted for significant confounders, female continuous ACE inhibitor users had significantly greater bone loss at total hip and femoral neck.rn Conclusion:Continuous use of ACE inhibitors over four years was associated with increased bone loss in total hip and femoral neck in older Chinese women.
  • 摘要:介绍合理应用钙剂的必要性和基本原则,同时指出钙也是双刃剑。过度补钙和细胞内钙超载都会造成不良反应或危害。只有正确地认识和应用钙剂和钙阻滞药,才能更好地发挥其造福人类的效用。
  • 摘要:目的:观察空心加压螺钉、动力髋螺钉(DHS)、股骨近端重建钉(PFN)、股骨近端锁定板在老年人股骨粗隆间骨折治疗中的应用和疗效。rn 方法:手术治疗Evans分型Ⅱ~Ⅴ型骨折122型,空心加压螺钉18例,DSH51例,PFN28例,股骨近端锁定板25例,比较四种治疗方法的效果。rn 结果:1例DHS术后1个月死于心肌梗死(90岁),其余病例均按期愈合。优良率空心钉组83.3%、DHS组84.3%、PFN组82.2%锁定板组88%。rn 结论:各种固定方法有其自身特点,应视患者全身情况、骨折类型以及医生的经验选择治疗方法。
  • 摘要:Introduction:Orthopedic surgeons are challenged by impaired or delayed fracture repair in osteoporotic bone, which requires either prolongation of rehabilitation process or salvage procedures to avoid delay in returning to work and /or even permanent care. Therapeutic stratagem should be defined according to identified molecular target. However,molecular mechanism of osteoporotic fracture repair remains poorly understood. In terms of histopathology, callus hardening is an important stage during fracture repair, which forms through two processes, the direct periosteam-dependent bone formation (intramembranous ossification) and the formation of bone through a cartilage intermediate (endochondral ossification). It has been reported that estrogen receptor beta (ERbeta) signaling participates in inhibiting angiogenesis in breast cancer cells in vitro using transient transfection assay. On the other hand, evidence from ERbeta gene knockout female mouse has demonstrated that, during bone development, ERbeta signaling participates in inhibiting both intramembranous and endochondral ossification.rn Material and Methods:30 ERbeta knockout (KO) and 30 wild type female mice (WT, C57BL/6) aged 3 months were used in this study. All mice were ovariectomised first. After 6 weeks, bilateral 0.8mm-diamter drill holes were made from the posterior to the anterior of the diaphysis of the femur. High resolution micro-CT (VivaCT 40 Scanco) was employed to in-vivo monitoring the repair process at day 0,3,7,10,14 and 21. Bone volume fraction (BV/TV) and bone mineral density (BMD) in defect region and marrow region were analyzed separately to evaluate the healing process. Serum samples were collect at each time point, bone formation marker PINP and bone resorption marker CTX were employed to describe bone turnover. Repeat measure ANOVA and Independent t-test was performed to analyze the data.rn Results and Discussion:Micro-CT 2D and 3D images showed larger callus size and better mineralization status in KO mice group compare to its wild type. The BV/TV and BMD in defect region increased from day 0 to 7, and rapidly reached the peak at day 14, and then dropped at day 21 in WT group, the values in KO group were significantly higher at day 7, 10, 14 and 21. The BV/TV and BMD in marrow region showed similar pattern with defect region in WT group while those in KO group were significantly higher at day 7, 10 and 14. Bone formation marker PINP reached the peak at day 10 in KO group while that reached the peak at day 14 in WT group. Bone resorption markers CTX, do not show significant difference between two groups. The results suggest blockade ERbeta could promote osteoporotic fracture repair without affect the remodeling phase.rn Conclusion:This is the first study employing high resolution micro-CT to in-vivo monitoring the fracture repair. ERbeta pathway is a potential therapeutic target for promoting osteoporotic fracture repair, highly selective ERbeta antagonist should be investigated as an osteoporotic fracture repair drug.
  • 摘要:目的:探讨三种内固定材料治疗老年股骨粗隆间骨折的临床疗效及其临床适应证。rn 方法:89例股骨粗隆间骨折患者中,采用动力髋螺钉(DHS)固定4l例,股骨近端解剖型钢板固定32例,股骨近端解剖型锁定钢板固定16例。rn 结果:经随访6个月~3年,优良率分别为92.8%,90.6%,93.8%。rn 结论:三种内固定材料以股骨近端解剖型锁定钢板最佳,但各有其适应证:对Evans Ⅰ、Ⅱ型和部分Ⅲ型可选用DHS固定,对Ⅳ,Ⅴ型可选用股骨近端解剖型钢板固定,对伴有严重骨质疏松的高龄者可选用股骨近端解剖型锁定钢板固定。临床应根据骨折类型,年龄、体质因素及骨质疏松程度等作综合分析,选择出最佳治疗方案。
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