第一章 骨质疏松症概论 2012年 (1).pptVIP

欧洲骨质疏松性骨折的经济负担 2010年有骨折发生246万例，也就是说： 每小时有280个新骨折发生 每年有34000人死于骨折相关疾病 *每天80人 *49%死于髋部骨折 如果及时治疗， 其中13%的新增骨折和20%的生活质量的丢失是可以避免的。 * WHO criteria * Prevalence data by decade from the Rochester project. This uses T -2.5 or below to define osteoporosis, in white women. Melton determined mean and SD for his population, which are different from that determined in NHANES III. Thus, prevalence figures from Rochester are different from those in NHANES. Note that prevalence increases with age at all there sites. However, the number of people diagnosed with osteoporosis varies according to which skeletal site is measured. This concept of discordance will be addressed in greater detail later in the course. Even if one uses spine, hip, and wrist, the prevalence is about 70% over age 80. Thus, not all women develop osteoporosis, not all have to be treated, and measurement of BMD is important. Note spine has higher prevalence than other sites in younger people because it has more cancellous bone and is thus more sensitive to bone loss. However, in elderly people prevalence based on the spine is lower than that of other sites because degenerative changes are more common at the spine and because more bone loss has occurred in the hip. * Stress fracture – a hairline fracture of bone resulting from repeated stress. Pathologic fracture: fracture that occurs in an area of bone previously weakened by another disease process such as tumor, infection, inherited bone disorder, etc. * Characteristics of Fractures in young people Long bones, Severe trauma, Men women. Characteristics of Fractures in older people: Hip, spine, wrist, Minimal trauma, Women men. This bimodal distribution of fractures is true only in developed countries. May not be true in developing countries (Asia/Africa). Note that the early peak occurs in men, involves long bones, and results form severe trauma such as motor vehicle accidents, sports, or occupational injuries. The later peak consists