在50岁以上的受试者中,骨折或近期骨折的临床危险因素(CRF)的存在是病例发现的基础.在临床上短期和长期骨折风险较高的患者(近期临床骨折或多发性CRF)中,使用双能量吸收法(DXA)测量骨矿物质密度(BMD)进一步评估,脊柱成像,跌倒风险评估和实验室检查有助于根据骨折风险的高度和可修改性做出治疗决策。治疗可用抗吸收和合成代谢药物,从治疗开始,需要终身策略来决定持续的,间歇性,和序贯疗法。准则的实施需要采取进一步举措来改善案件调查,公众对骨质疏松症的认识以及国家评估和治疗报销政策。
In subjects older than 50 years, the presence of clinical risk factors (CRFs) for fractures or a recent fracture is the cornerstone for case finding. In patients who are clinically at high short- and long-term risk of fractures (those with a recent clinical fracture or with multiple CRFs), further assessment with bone mineral density (BMD) measurement using dual-energy absorptiometry (DXA), imaging of the spine, fall risk evaluation and laboratory examination contributes to treatment decisions according to the height and modifiability of fracture risk. Treatment is available with anti-resorptive and anabolic drugs, and from the start of treatment a lifelong strategy is needed to decide about continuous, intermittent, and sequential therapy. Implementation of
guidelines requires further initiatives for improving case finding, public awareness about osteoporosis and national policies on reimbursement of assessment and therapy.