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双膦酸盐类药物临床用于治疗骨质疏松症、变形性骨炎和其他代谢性骨病、多发性骨髓瘤以及与肿瘤转移相关的骨骼疾病。该类药物通过抑制破骨细胞介导的骨吸收而产生临床治疗作用。然而,双膦酸盐类药物,尤其是静脉用双膦酸盐类药物有致颌骨骨坏死的危险。目前,国内尚未有该类药物致下颌骨坏死的报道。作者报告1例口服双膦酸盐类药物阿仑膦酸钠(Alendronate,商品名福善美,Fosamax)致下颌骨骨坏死病例,并结合文献对双膦酸盐性颌骨坏死的发病机制、临床表现及其预防和治疗进行讨论。
Bisphosphonates are clinically useful in the treatment of osteoporosis, osteitis deformans and other metabolic bone diseases, multiple myeloma, and skeletal disorders associated with tumor metastasis. These drugs have a clinical therapeutic effect by inhibiting osteoclast-mediated bone resorption. However, bisphosphonates, especially intravenous bisphosphonates, are at risk of jaw osteonecrosis. At present, there is no such report of mandibular necrosis in China. The authors report a case of mandibular osteonecrosis caused by the oral bisphosphonates Alendronate (Fosamax) and the literature review of the pathogenesis of bisphosphonate jaw necrosis, clinical Performance and prevention and treatment of the discussion.