1, etiology and related diseases
Old age OP and age, gender, 65 years old, female older OP happening hazardous. The influence of gender on the amount of bone is mainly related to hormones. In the entire physiological process of human bones, the amount of bone will change with age growth. With the growth of age, the hypothalamus-pituitary-gonad shaft will change, especially in many hormone concentrations in the female menopause, such as estrogen, growth hormone, thyroid hormone levels, and increased parathyroid hormone levels, These hormones have changed alone or synergistic, which reduces osteocytosis, enhancement of osteoblasts, causing bone conversion acceleration, and increased bone loss.
Marriage, the academic qualifications affect the occurrence of old OP, widowed or divorced, the junior high school and the following academic qualifications are high. The low level of education is less economical, social contact and support, and accepts less health education information channels, thus self-care awareness and behavior.
Eating habits are related to the occurrence of elderly OP, the staple food is mainly, fish and water products, dairy products, and small intake of soy-intake have a large possibility of OP. This type is rich in protein. The total intake of the elderly is less, the protein intake can cause the plasma protein content to decrease, causing the shortcomings of bone substanceous synthesis, the new bone formation will be obvious, and OP is easy to cause OP fractures.
II. Differential diagnosis
The elderly suffer from osteoporosis often have a painful pain, soft knee acid soft and lower limbs, muscle spasm and other symptoms, these symptoms have diagnosed osteoporosis Lack of specificity, in accordance with the level of bone volume, osteoporus image performance and laboratory bone conversion biochemical indicators, and combined with relevant risk factors.
Bone density determination: bone density measurement is the main quantitative basis for diagnosing osteoporosis, and now there is a single photon bone density, single energy X-ray bone density, DEXA, quantitative CT, quantitative ultrasound bone Density instrument and other techniques measuring bone density, but only DEXA is the bone density (g / cm2) measured on the upper end of lumbar vertebrae and femur is an internationally recognized osteoporosis diagnostic indicator, known as the diagnosis of "gold standard".
International Clinical Bone Dental Society (ISCD) Confucite documents on bone density measurement showed that DEXA measured the back of the spine 1-4 lumbar vertebrae and hip femoral neck, large braglon, full hip bone density has a diagnosis Application of WHO diagnostic criteria: T value 1 1.0s is normal,
lumbar vertebrae, femur upper and calcaneus X-ray examination: observe the form, arrangement and density of the bone beam, and conduct semi-quantitative measurement diagnosis of osteoporosis It has the advantages of simple, widely used.
Bone conversion marker assay: detection of blood, urine osteogenesis released, the bone absorption marker, which can be transformed, and the pathological characteristics of bone reconstruction of the elderly human osteoporosis Judging, helping the pathological classification of osteoporosis of the elderly, and can be used earlier than the change in bone reconstruction. Bone formation label commonly used bone-specific alkaline phosphatase, osteocalcin and I-type front collaborator carboxer endopeptide, etc., bone absorption marker common anti-alcoholic acid phosphatase, uric acid-uric acid-pyridine cross-linking, deoxycopyridine crosslinking Urinary I-type collagen-free carboxy-terminal peptide or urinary I-type collagen-bonding-based terminal peptide and urine Ca and creatinine ratio.
In addition, some risk factors are closely related to the occurrence of osteoporosis in the elderly, such as age, low bone density, low weight, has brittle fracture, crispy fracture, 54-year-old Or dual ovaro, the body is shortened, easy to fall, long-term low calcium and vitamin D patient, the amount of activity and long-term smoking, excessive drinking or coffee, etc., should be an important reference index of the osteoporosis diagnosis of the elderly, in the old age The human osteoporosis needs to be queried in detail for the related volatility.
3, treatment principle and prevention
1, basic drug treatment
( 1) Application of calcitonin drug
The application of calcitonin drugs mainly has two types of salmon calcium and squid calcium, their characteristics It is the synthesis of osteoblasts and promotes the synthesis of osteoblasts, and is a more gentle regulatory drug. Calcitonin can promote osteoconduct synthesis bone formation factor, such as ALP, IGF-1, BGP, etc., and can inhibit the synthesis of osteoblasts, now the calcitonin is often combined with high doses of Afi osteogenic alcohol for long-term treatment of senile Osteoporosis.
(2) Application of Parathyroid
Many research surveys now show that parathyroidism The formation has a certain role; many studies have shown that the use of small doses of parathyroxin can improve the structure of the bone and improve the biogenics intensity of the bone.
(3) Application of strontium salt drugs
The role of strontium salt drugs on bone tissue is more clear, it can Inhibit the absorption of bones and the formation of bone.
2, rational motion and physicochemical treatment
bones and muscle secret, appropriate exercise can reach bones and muscles Coordination, can improve the strength of the skeletal muscle group and improve the activity of the osteoarthrosis, long-term scientific and reasonable exercise can improve the bone density, the elderly can participate in some fitness exercises, such as walking, Taijiquan, Taiji sword, etc. Both are beneficial to prevent osteoporosis in the elderly. In some physical therapy, some low-frequency pulse electromagnetic fields, low-intensity pulse ultrasonic stimulation, is also an effective method for preventing elderly osteoporosis.
3, periodically check
For the elderly, the bone density should be performed regularly in order to understand osteoporosis The situation is achieved early discovery, the purpose of early treatment.