CAJ | 학술논문

骨质疏松症（ OP）是一种以骨量低下、骨微结构破坏，导致骨脆性增加、易发生骨折为特征的全身性疾病。近年来，随着人口老龄化社会的到来，高龄老年OP患者越来越多。高龄老年OP的发生与高龄老人体内性激素（包括雌激素和雄激素）水平下降、营养物质摄入减少、活动量下降、某些疾病等因素有关。高龄老年OP患者不仅脆性骨折的发生率高，而且骨折后容易致残、致死。高龄老年OP诊治的基本内容包括普查和健康教育、选择合适的抗OP药物、及时调整治疗方案等。骨转换标志物（ BTMs）的检测是高龄老年OP患者选择抗OP药物的重要依据，一般来说，对BTMs较高的高龄骨量减少和OP患者，应选择使用抗骨吸收药物，如双膦酸盐类和选择性雌激素受体调节剂等，而对BTMs较低的高龄OP患者，应选择使用促骨形成药物（如重组人甲状旁腺激素1-34）。要注意根据高龄老年OP患者骨密度和BTMs的变化，及时调整治疗方案，避免长期使用双膦酸盐类药物。
골질소송증（ OP）시일충이골량저하、골미결구파배，도치골취성증가、역발생골절위특정적전신성질병。근년래，수착인구노령화사회적도래，고령노년OP환자월래월다。고령노년OP적발생여고령노인체내성격소（포괄자격소화웅격소）수평하강、영양물질섭입감소、활동량하강、모사질병등인소유관。고령노년OP환자불부취성골절적발생솔고，이차골절후용역치잔、치사。고령노년OP진치적기본내용포괄보사화건강교육、선택합괄적항OP약물、급시조정치료방안등。골전환표지물（ BTMs）적검측시고령노년OP환자선택항OP약물적중요의거，일반래설，대BTMs교고적고령골량감소화OP환자，응선택사용항골흡수약물，여쌍련산염류화선택성자격소수체조절제등，이대BTMs교저적고령OP환자，응선택사용촉골형성약물（여중조인갑상방선격소1-34）。요주의근거고령노년OP환자골밀도화BTMs적변화，급시조정치료방안，피면장기사용쌍련산염류약물。
Osteoporosis ( OP) is a disease characterized by low bone mass and microarchitectural deterioration of the bone tissue, which leads to increased bone fragility and consequent risk of bone fractures.In the recent years, along with the population ageing in the society, the number of OP in the elderly is getting more and more.The mechanism of OP in the elderly is associated with low sex hormone level, poor nutritional status, lack of motility, some diseases, etc.Elder OP patients are easy to suffer frangible fractures, which lead to high rate of disability and death.The basic content of diagnosis and treatment on OP in the elderly includes general investigation and health education, appropriate anti-osteoporosis drug selection, and proper therapeutic strategy.The detection of bone turnover markers ( BTMs) serves as a basis for selecting anti-osteoporosis drugs.In general, elder osteopenia patients with high BTMs need to choose antiresorptive drugs, such as bisphosphonates and selective estrogen receptor modulators ( SERMs) .Those whose BTMs are lower need to take bone anabolic drugs such as the 1-34 fragment of recombinant human parathyroid hormone ( teriparatide) .It is necessary for elder OP patients to adjust therapeutic plan on the basis of bone mineral density and BTMs variation, and to avoid long-term use of bisphosphonates.