■继发性骨质疏松症是潜在的疾病或其治疗导致骨量减少和骨结构恶化的病症,增加骨折的风险。儿童期和青春期诊断和治疗的重要性是由于其长期的负面影响。在这项研究中,我们的目标是确定诊断结果,治疗功效,儿童期继发性骨质疏松症的随访特点。
■在2000年1月至2021年1月期间诊断为继发性骨质疏松症的61例患者被纳入研究。这项研究是一项横断面和描述性研究。当诊断出原发性潜在疾病并接受继发性骨质疏松症治疗时,研究参与者必须未满18岁。从患者档案中收集患者数据。患者数据是从医院的患者档案中获得的,并通过IBMSPSSStatisticsforWindows20.0版(IBMCorp,Armonk,NY,美国)。
■对61例患者(28名女性/33名男性)进行了评估。继发性骨质疏松患者最常见的基础疾病是炎症性疾病(57.7%),神经肌肉疾病(26.2%),免疫缺陷(13.1%),急性淋巴细胞白血病(8.2%),代谢性疾病(8.2%),和实体器官移植。(8.2%),骨髓移植(6.6%)和癫痫(6.6%)。诊断为继发性骨质疏松症的平均实际年龄为11.89±4.88岁。在潜在的原发性慢性疾病发作后6.39±5.13年,对他们进行了骨质疏松症评估。78.7%的患者有一种或多种慢性药物使用。系统性类固醇使用率为59%,化疗药物23%,免疫调节药物19.7%,抗癫痫药8.2%,吸入类固醇4.9%,IVIG1.6%,和抗结核药物1.6%。此外,1.6%的患者使用睾酮作为替代,3.3%L-甲状腺素,1.6%的雌激素,和1.6%的生长激素。在49.2%的患者中检测到骨痛。所有患者治疗前均有椎体骨折。对45例继发性骨质疏松症患者给予双膦酸盐治疗。治疗后6个月,平均骨密度(BMD)和骨矿物质含量值有统计学意义的增加,(p<0.001)。年龄和身高年龄的BMDZ评分值显着增加(p<0.001)。患者的BMD值在治疗后平均增加了31.15%。双膦酸盐治疗后,患者的骨折数量和骨痛均显着减少(p<0.01)。当比较接受和未接受类固醇治疗的患者时,两组在双膦酸盐治疗中的获益相似.
■继发性骨质疏松症是一种受多种因素影响的疾病,例如引起骨质疏松症的原发性疾病,长期使用药物,尤其是类固醇.如果不及时治疗,骨质疏松症会导致骨痛等重要疾病,骨折,固定化,减少骨骼的线性生长。当用于治疗儿童继发性骨质疏松症时,双膦酸盐可显著改善BMD并降低骨折风险。
UNASSIGNED: Secondary osteoporosis is a condition when the underlying disease or its treatment causes the bone mass to decrease and the bone structure to deteriorate, increasing the risk of fracture. The importance of diagnosis and treatment during childhood and adolescence is due to its long-term negative effects. In this study, our objectives were to determine the diagnostic findings, treatment efficacy, and follow-up characteristics of childhood with secondary osteoporosis.
UNASSIGNED: 61 patients diagnosed with secondary osteoporosis between January 2000 and January 2021 were included in the study. The research is a cross-sectional and descriptive study. Study participants had to be under 18 years of age when the primary underlying disease was diagnosed and received treatment for secondary osteoporosis. Patient data were collected from patient files. Patient data were obtained from patient files in hospitals and were interpreted through the IBM SPSS Statistics for Windows version 20.0 (IBM Corp, Armonk, NY, USA).
UNASSIGNED: 61 patients (28 women/33 men) were evaluated. The most common underlying primary diseases in patients with secondary osteoporosis were inflammatory diseases (57.7%), neuromuscular diseases (26.2%), immunodeficiency (13.1%), acute lymphoblastic leukemia (8.2%), metabolic diseases (8.2%), and solid organ transplantation. (8.2%), bone marrow transplantation (6.6%) and epilepsy (6.6%). The average chronological age when secondary osteoporosis was diagnosed was 11.89±4.88 years. They were evaluated for osteoporosis 6.39±5.13 years after the onset of the underlying primary chronic diseases. 78.7% of the patients had one or more chronic drug use. Systemic steroid use was 59%, chemotherapeutics 23%, immunomodulatory drugs 19.7%, antiepileptic drugs 8.2%, inhaled steroids 4.9%, IVIG 1.6%, and antituberculosis drugs 1.6%. Additionally, 1.6% of the patients were using testosterone as replacement, 3.3% L-Thyroxine, 1.6% estrogen, and 1.6% growth hormone. Bone pain was detected in 49.2% of the patients. All patients had vertebral fractures before treatment.
Bisphosphonate treatment was given to 45 patients with secondary osteoporosis. There was a statistically significant increase in mean bone mineral density (BMD) and bone mineral content values six months after treatment, (p<0.001). There was a significant increase in BMD Z-score values for chronological and height age (p<0.001). The patients\' BMD values increased on average by 31.15% with treatment. Following
bisphosphonate treatment, there was a significant reduction in both fracture number and bone pain in patients (p<0.01). When patients who received and did not receive steroid treatment were compared, both groups received similar benefits from
bisphosphonate treatment.
UNASSIGNED: Secondary osteoporosis is a condition that is influenced by many factors, such as the primary disease causing osteoporosis, chronic medication use, especially steroids. If left untreated, osteoporosis leads to important diseases such as bone pain, bone fractures, immobilization, and reduced linear growth of bone. When used to treat childhood secondary osteoporosis, Bisphosphonates significantly improve BMD and reduce fracture risk.