乙型肝炎患者骨质疏松的发生机制及临床防治

韩一凡; 徐小元

doi:10.3969/j.issn.1001-5256.2020.07.036

乙型肝炎患者骨质疏松的发生机制及临床防治

DOI: 10.3969/j.issn.1001-5256.2020.07.036

北京大学第一医院感染疾病科

基金项目:

国家科技重大专项课题(2018ZX09201016,2017ZX10302201-004-009,2017ZX10203202-003)；北京市科技计划项目(D161100002716003,D161100002716002,D171100003117005)；

详细信息

中图分类号: R512.62;R580
计量
- 文章访问数: 642
- HTML全文浏览量: 22
- PDF下载量: 698
- 被引次数: 0
出版历程
- 出版日期: 2020-07-20

Pathogenesis and clinical prevention and treatment of osteoporosis in patients with hepatitis B

Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China

Research funding:

摘要

摘要:
随着临床治疗水平的提升和患者寿命的增长,骨质疏松在乙型肝炎患者中的发生率逐渐升高。但乙型肝炎不同疾病阶段对骨质疏松影响的具体机制较为复杂且尚不明确,针对乙型肝炎患者骨质疏松防治的研究也相对缺乏。综述了乙型肝炎患者骨质疏松发生机制及临床防治,以期更好地指导临床管理和治疗。
- 乙型肝炎 /
- 骨质疏松 /
- 肝硬化
Abstract:
With the improvement in clinical treatment and the increase in life expectancy,the incidence rate of osteoporosis is gradually increasing in patients with hepatitis B. However,the specific mechanism of different stages of hepatitis B on osteoporosis is still complex and remains unclear,and there are few studies on the prevention and treatment of osteoporosis in patients with hepatitis B. This article reviews the pathogenesis and clinical prevention and treatment of osteoporosis in patients with hepatitis B,in order to provide better guidance for clinical management and treatment.
- hepatitis B /
- osteoporosis /
- liver cirrhosis

HTML全文

参考文献(37)

[1]LIU J,LIANG W,JING W,et al.Countdown to 2030:Eliminating hepatitis B disease,China[J].Bull World Health Organ,2019,97(3):230-238．

[2]GIOULEME OI,VYZANTIADIS TA,NIKOLAIDIS NL,et al.Pathogenesis of osteoporosis in liver cirrhosis[J].Hepatogastroenterology,2006,53(72):938-943．

[3]NAKCHBANDI IA.Osteoporosis and fractures in liver disease:Relevance,pathogenesis and therapeutic implications[J].World J Gastroenterol,2014,20(28):9427-9438．

[4]CAO Y,XU XY.Association between osteopenia and osteoporosis in patients with viral hepatitis[J].Natl Med J China,2014,94(43):3450-3452.(in Chinese)曹颖，徐小元．病毒性肝炎患者的骨量减少与骨质疏松关系[J]．中华医学杂志，2014,94(43):3450-3452．

[5]CHEN CH,LIN CL,KAO CH.Association between chronic hepatitis B virus infection and risk of osteoporosis:A nationwide populationbased study[J].Medicine(Baltimore),2015,94(50):e2276．

[6]YENICE N,GMRAH M,MEHTAP O,et al.Assessment of bone metabolism and mineral density in chronic viral hepatitis[J].Turk JGastroenterol,2006,17(4):260-266．

[7]ZHANG Q,CHENG J,ZHAO CS,et al.Study on the changes of serum osteoprotegerin and receptor activator for nuclear factor-κB ligand in patients with chronic hepatitis B[J/CD].Chin J Exp Clin Infect Dis(Electronic Edition),2013,7(6):850-854.(in Chinese)张强，成军，赵昌松，等．慢性乙型肝炎患者血清骨保护素和核因子κB受体活化因子配体变化的研究[J/CD]．中华实验和临床感染病杂志(电子版)，2013,7(6):850-854．

[8]SCHIEFKE I,FACH A,WIEDMANN M,et al.Reduced bone mineral density and altered bone turnover markers in patients with noncirrhotic chronic hepatitis B or C infection[J].World J Gastroenterol,2005,11(12):1843-1847．

[9]SUN YL,ZHANG LH,FANG HL,et al.Measurement of the activities of interleukin-1,interleukin-6,and tumor necrosis factor-αin patients with viral hepatitis[J].Chin J Microbiol Immunol,1994,14(3):187-189.(in Chinese)孙永良，张立煌，方海林，等．病毒性肝炎患者IL-1、IL-6和TNFα活性的检测[J]．中华微生物学和免疫学杂志，1994,14(3):187-189．

[10]LEE YM,FUJIKADO N,MANAKA H,et al.IL-1 plays an important role in the bone metabolism under physiological conditions[J].Int Immunol,2010,22(10):805-816．

[11]WU Q,ZHOU X,HUANG D,et al.IL-6 enhances osteocyte-mediated osteoclastogenesis by promoting JAK2 and RANKL activity in vitro[J].Cell Physiol Biochem,2017,41(4):1360-1369．

[12]NAKCHBANDI IA,MITNICK MA,LANG R,et al.Circulating levels of interleukin-6 soluble receptor predict rates of bone loss in patients with primary hyperparathyroidism[J].J Clin Endocrinol Metab,2002,87(11):4946-4951．

[13]BLASCHKE M,KOEPP R,CORTIS J,et al.IL-6,IL-1β，and TNFαonly in combination influence the osteoporotic phenotype in Crohn's patients via bone formation and bone resorption[J].Adv Clin Exp Med,2018,27(1):45-56．

[14]RUIZ-GASPS,MARTINEZ-FERRER A,GUAABENS N,et al.Effects of bilirubin and sera from jaundiced patients on osteoblasts:Contribution to the development of osteoporosis in liver diseases[J].Hepatology,2011,54(6):2104-2113．

[15]CHEN RS,YAN DW,WANG JP,et al.Changes in biochemical markers of bone turnover,sex hormones and calcium regulating hormones in male patients with chronic hepatitis B induced liver cirrhosis[J].Chin J Osteoporos,2002,8(3):44-45.(in Chinese)陈如山，阎德文，王建平，等．慢性乙型肝炎性肝硬化症男性患者血清性激素、钙调节激素和骨转换指标的变化[J]．中国骨质疏松杂志，2002,8(3):44-45．

[16]ROUILLARD S,LANE NE.Hepatic osteodystrophy[J].Hepatology,2001,33(1):301-307．

[17]TSAI CF,LIU CJ,CHEN TJ,et al.Increased incidence of orthopedic fractures in cirrhotic patients:A nationwide population-based study[J].J Hepatol,2013,58(4):706-714．

[18]Chinese Society of Hepatology,Chinese Medical Association.Guidelines on the management of ascites and complications in cirrhosis[J].J Clin Hepatol,2017,33(10):1847-1863.(in Chinese)中华医学会肝病学分会．肝硬化腹水及相关并发症的诊疗指南[J]．临床肝胆病杂志，2017,33(10):1847-1863．

[19]VERBALIS JG,BARSONY J,SUGIMURA Y,et al.Hyponatremiainduced osteoporosis[J].J Bone Miner Res,2010,25(3):554-563．

[20]LIM LS,FINK HA,BLACKWELL T,et al.Loop diuretic use and rates of hip bone loss and risk of falls and fractures in older women[J].J Am Geriatr Soc,2009,57(5):855-862．

[21]HAMIDI MS,GAJIC-VELJANOSKI O,CHEUNG AM.Vitamin K and bone health[J].J Clin Densitom,2013,16(4):409-413．

[22]Chinese Society of Hepatology,Chinese Medical Association;Chinese Society of Gastroenterology,Chinese Medical Association;Chinese Society of Endoscopy,Chinese Medical Association.Guidelines for the diagnosis and treatment of esophageal and gastricvariceal bleeding incirrhotic portal hypertension[J].J Clin Hepatol,2016,32(2):203-219.(in Chinese)中华医学会肝病学分会，中华医学会消化病学分会，中华医学会内镜学分会．肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J]．临床肝胆病杂志，2016,32(2):203-219．

[23]ANTOCI V Jr,ADAMS CS,HICKOK NJ,et al.Antibiotics for local delivery systems cause skeletal cell toxicity in vitro[J].Clin Orthop Relat Res,2007,462:200-206．

[24]HOLTOM PD,PAVKOVIC SA,BRAVOS PD,et al.Inhibitory effects of the quinolone antibiotics trovafloxacin,ciprofloxacin,and levofloxacin on osteoblastic cells in vitro[J].J Orthop Res,2000,18(5):721-727．

[25]COSTA-RODRIGUES J,MARTINS EG,FERNANDES MH.Induced osteoclastogenesis by fluoroquinolones in unstimulated and stimulated human osteoclast precursor cells[J].Bone,2012,51(1):17-27．

[26]Liver Failure and Artifical Liver Group,Chinese Society of Infectious Diseases,Chinses Medical Association,Severe Liver Disease and Artificial Liver Group,Chinese Society of Hepatology,Chinese Medical Association.Guidelines for diagnosis and treatment of liver failure[J].J Clin Hepatol,2019,35(1):38-44.(in Chinese)中华医学会感染病学分会肝衰竭与人工肝学组，中华医学会肝病学分会重型肝病与人工肝学组．肝衰竭诊治指南(2018年版)[J]．临床肝胆病杂志，2019,35(1):38-44．

[27]BROWN TT,HOY J,BORDERI M,et al.Recommendations for evaluation and management of bone disease in HIV[J].Clin Infect Dis,2015,60(8):1242-1251．

[28] Chinese Society of Osteoporosis and Bone Mineral Research.Gidelines for the diagnosis and management of primary osteoporosis(2017)[J].Chin J Osteoporos,2019,25(3):281-309.(in Chinese)中华医学会骨质疏松和骨矿盐疾病分会．原发性骨质疏松症诊疗指南(2017)[J]．中国骨质疏松杂志，2019,25(3):281-309．

[29]CAMACHO PM,PETAK SM,BINKLEY N,et al.American association of clinical endocrinologists and American college of endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis-2016[J].Endocr Pract,2016,22(Suppl4):1-42．

[30]ZHANG W,GONG H,SU Z,et al.Risk factors associated with hepatic osteopathy in HBV related cirrhosis measured by liver stiffness:An observational study[J].Medicine(Baltimore),2019,98(31):e16628．

[31]MARQUES A,LOURENO，DA SILVA JA,et al.The burden of osteoporotic hip fractures in Portugal:Costs,health related quality of life and mortality[J].Osteoporos Int,2015,26(11):2623-2630．

[32]Chinese Society of Hepatology,Chinese Medical Association.Guidelines on the management of hepatic encephalopathy in cirrhosis[J].JClin Hepatol,2018,34(10):2076-2089.(in Chinese)中华医学会肝病学分会．肝硬化肝性脑病诊疗指南[J]．临床肝胆病杂志，2018,34(10):2076-2089．

[33]BMEUR C,BUTTERWORTH RF.Nutrition in the management of cirrhosis and its neurological complications[J].J Clin Exp Hepatol,2014,4(2):141-150．

[34]HAJIABBASI A,SHAFAGHI A,FAYAZI HS,et al.The factors affecting bone density in cirrhosis[J].Hepat Mon,2015,15(4):e26871．

[35]SHIOMI S,MASAKI K,HABU D,et al.Calcitriol for bone disease in patients with cirrhosis of the liver[J].J Gastroenterol Hepatol,1999,14(6):547-552．

[36]CASTELO-BRANCO C,CORTS X,FERRER M,et al.Treatment persistence and compliance with a combination of calcium and vitamin D[J].Climacteric,2010,13(6):578-584．

[37]Chinese Society of Hepatology,Chinese Medical Association.Chinese guidelines on the management of liver cirrhosis[J].J Clin Hepatol,2019,35(11):2408-2425.(in Chinese)中华医学会肝病学分会．肝硬化诊治指南[J]．临床肝胆病杂志，2019,35(11):2408-2425.

施引文献

资源附件(0)

访问统计