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表5-5 ADFR治疗方案
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四、总 结
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OP的预防可通过筛查高危人群、改善饮食结构、适当运动等方式实现。在OP临床治疗中，补充钙和维生素D是基本措施，在用其他药物治疗同时更需要注意钙和维生素D的补充。二膦酸盐、SERMs、降钙素都被临床资料证明能够降低OP骨折发生率（各种防治OP药物的适应证、常规推荐剂量具体见表5-6）。二膦酸盐是防治OP的一线药物，每周1次、每月1次或静脉给药方法可以减少上消化道反应、增加了依从性和耐受性，用二膦酸盐治疗OP还需要注意下颌骨坏死问题；SERMs减少PMOP骨折的同时降低了乳腺癌风险，却提高了静脉栓塞的风险，所以近期有血栓栓塞病史者禁用。PTH是目前唯一能够增加骨合成代谢的药物，每天皮下注射一次PTH能够增加BMD, 减少骨折，所以有人想象是否可以用钙离子受体抑制剂促进内源性PTH合成以增加骨合成或者发现一种PTH的类似物可以增加骨合成却不增加骨吸收，而有关PTH与各种药物的联合治疗还有待进一步研究。
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表3 各种防治OP药物的用法及常规推荐剂量
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【思考题】
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1.骨质疏松症有哪些防范措施？
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2.试述骨质疏松症的药物治疗。
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参考文献
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[3] 李洲，马宝通．骨质疏松性骨折的预防研究进展．中华临床医学杂志，2007，8(11):31-34.
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