Остеопороз при гормональной терапии рака предстательной железы и маркеры ремоделирования костной ткани

Автор: Сивков А.В., Кешишев Н.Г., Рабинович Э.З., Трудов А.А.

Журнал: Экспериментальная и клиническая урология @ecuro

Статья в выпуске: 4, 2015 года.

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Остеопороз может развиваться при различных состояниях: онкологических, эндокринологических и ревматологических заболеваниях, при болезнях органов пищеварения, почек, легких, как осложнение при приеме некоторых медикаментозных средств (глюкокортикостероиды, аналоги гонадотропин-рилизинг-гормона и др.). По данным литературы, через два года лечения аналогами гонадотропин-релизинг-гормона (ГнРГ) остеопороз развивается у 40-50% больных раком предстательной железы (РПЖ). В настоящее время для диагностики остеопороза золотым стандартом является остеоденситометрия, однако это не всегда позволяет выявить нарушения костного метаболизма при онкологических заболеваниях, особенно на ранних стадиях. В обзоре показан мировой опыт использования биохимических маркеров костной резорбции (кальций, гидроксипролин, NTX, CTX, PYD, DPD, TRAP-5b, костный сиалопротеин - BSP) и маркеров синтеза костной ткани (остеокальцин, КЩФ, АКФ, ККФ), их преимущества и недостатки. Уровень этих маркеров повышается у большинства пациентов с остеопорозом и метастазами в кости. Изменение маркеров костного метаболизма в сыворотке крови является релевантным методом оценки эффективности антирезорбтивной терапии вторичного остеопороза, в том числе, вызванного антиандрогенной терапией РПЖ. Основными рекомендованными маркерами являются СТХ и PINP. В настоящее время при местнораспространенном и метастатическом РПЖ назначение гормональной терапии входит в стандарт первой линии помощи данной категории больных. Бисфосфонаты (Резорба) - основные лекарственные средства для лечения остеопороза, вызванного назначением аналогов ГнРГ. Рассмотрены различные виды режимов дозирования и длительности антирезорбтивной терапии бисфосфонатами.

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Остеопороз, диагностика, биохимические маркеры, костные метастазы, резорбция костной ткани, бисфосфонаты, золендроновая кислота

Короткий адрес: https://sciup.org/142188069

IDR: 142188069

Список литературы Остеопороз при гормональной терапии рака предстательной железы и маркеры ремоделирования костной ткани

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