摘要
目的:探讨脑卒中合并骨质疏松症的发生情况和发病机制,为其诊断和防治提供理论依据。资料来源:应用计算机检索PubMed数据库1970-01/2004-12与脑卒中和骨质疏松相关的文章。检索词为“stroke,osteoporosis,bonemineradensity,cerebralvasculardiseases”限定文章语言种类为English。同时计算机检索中国期刊全文数据库(CNKI)1990-01/2005-01期间相关文献,检索词为“脑卒中,骨质疏松症,骨密度,脑血管病”限定文章语言种类为中文。资料选择:对资料进行初审,选取与脑卒中和骨质疏松症有关的文献。纳入标准:①随机对照临床研究。②前后对照临床研究。排除标准:①重复性研究。②综述文献。资料提炼:共收集到89篇关于脑卒中和骨质疏松症研究的文章,其中52篇属于重复性研究和综述文献,对其余37篇进行分类整理用于综述。资料综合:37篇文献中包括22个随机对照临床研究,15个前后对照临床研究,证实了脑卒中后骨质疏松症主要是因运动减少、钙、镁离子代谢异常和甲状旁腺激素增加、维生素D缺乏、神经营养不良和各细胞因子作用;其临床表现除了运动、感觉障碍外,随着病情的发展会逐渐出现乏力,腰背酸痛和骨痛,以及骨密度减少和骨代谢异常。其治疗除了积极治疗脑卒中,还应加强运动,并适当给予治疗骨质疏松的药物。结论:脑卒中可合并骨质疏松症,主要因为瘫痪和制动,对脑卒中患者定期行骨密度等测定,早期发现骨质疏松改变及早治疗,减少并发症,有利于提高患者生活质量。
OBJECTIVE： To investigate the occurrence and pathogenesis of osteoporosis in stroke, so as to provide theoretical bases for the diagnosis and prevention and cure. DATA SOURCES： A computer-based search of the PubMed database was undertaken to identify the articles about stroke and osteoporosis published in English between January 1970 and Decenff, er 2004 by using keywords of “stroke, osteoporosis, bone mineral density, cerebrovascular diseases”. Chinese relevant articles published from January 1990 to January 2005 were also searched in China National Knowledge Infrastructure （CNKI） with computer by using the keywords of “stroke, osteoporosis, bone mineral density, cerebrovaseular diseases”. STUDY SELECTION： Primary check-up was performed, and the articles about stroke and osteoporosis were selected. Inclusive criteria：① randomized controlled clinical studies; ② before-after controlled clinical studies. Exclusive criteria：① repetitive studies; ② reviews. DATA EXTRACTION： Totally 89 articles about stroke and osteoporosis were collected, 52 of them were excluded because they were repeated studies or reviews, and the rest 37 articles were classified and sorted for DATA SYNTHESIS： Of the 37 articles, 22 were randomized controlled clinical studies, the rest 15 were before-after controlled clinical studies. It was proved that post-stroke osteoporosis was mainly caused by decrease of exercise, metabolic abnormality of calcium and magnesium ions, increase of parathyroid hormone, deficiency of vitamin D, neurological malnutrition and the together effect of various cells. Besides motor and sensory disorders, the clinical manifestations were the inertia, pain in waist and back and bone ache gradually occurred with the development of disease, decrease of bone mineral density and abnormality of bone metabolism. Beside active treatment of stroke, exercise should be reinforced and proper drugs for osteoporosis also should be given in the treatment. CONCLUSION： Osteoporosis is a significant complication of stroke. Hemiosteoporosis usually contributes to paralysis and immobilization. The bone mineral density of stroke patients should he determined regularly to earlier detect and treat ostenporosis and decrease the complications, which is good for the improvement of their quality of life.
出处
《中国临床康复》
CSCD
北大核心
2005年第29期147-149,共3页
Chinese Journal of Clinical Rehabilitation
基金
河北省卫生厅医学科研重点课题(04264)~~
