社区治疗骨质疏松症应用阿仑膦酸钠应注意上消化道问题

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目的调查应用阿仑膦酸钠的社区骨质疏松患者上消化道异常的情况及患者对其的认知状况。方法抽取180例在社区随访的骨质疏松患者,进行问卷调查和上消化道气钡双重造影检查。结果 180例调查对象中,初次接受阿仑膦酸钠处方时被询问过有关上消化道疾病方面问题的比例为8.3%;被建议胃镜或上消化道造影检查的比例为3.3%;知晓服用阿仑膦酸钠禁忌证的比例为6.7%;服用阿仑膦酸钠产生上消化道症状后向医生主动咨询的比例为11.1%。78例被检出存在各类上消化道异常,均无自觉症状,检出率43.3%,其中75例存在1种病变,3例存在2种病变,合计病变例数为81例:食管病变6例(8%),膈肌病变2例(2%),胃部病变57例(70%),十二指肠病变16例(20%)。结论在无上消化道症状的老年骨质疏松患者中,各类上消化道病变检出率较高,社区医生和骨质疏松患者务必提高对阿仑膦酸钠使用禁忌证和可能产生的上消化道不良反应的重视程度。 Objective To investigate the prevalence of upper gastrointestinal abnormalities in patients with community-based osteoporosis using alendronate and their cognitive status. Methods 180 patients with osteoporosis who were followed up in the community were enrolled in this study. Questionnaire investigation and double contrast barium in upper gastrointestinal tract were performed. Results Of the 180 subjects who were asked about alendronate sodium for the first time they were asked about the disease in the upper digestive tract, the proportion was 8.3%; the ratio of gastroscopy or upper gastrointestinal imaging was suggested to be 3.3%; The ratio of sodium to glaucoma contraindications was 6.7%; the rate of active consultation with doctors after taking alendronate in upper gastrointestinal symptoms was 11.1%. 78 cases were detected in all kinds of upper gastrointestinal abnormalities, no symptoms, the detection rate was 43.3%, of which 75 cases there is a disease, three cases there are two kinds of lesions, the total number of lesions was 81 cases: Esophageal lesions 6 (8%), diaphragmatic lesion in 2 cases (2%), gastric lesion in 57 cases (70%) and duodenal lesion in 16 cases (20%). Conclusions In elderly osteoporosis patients without symptoms of upper gastrointestinal tract, the prevalence of various upper gastrointestinal lesions is high. Community doctors and patients with osteoporosis must improve the use of alendronate contraindications and possible outcomes The importance of adverse reactions to the digestive tract.
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