According to the differential diagnosis of 4.4.1 need detection of blood and urine routine, liver and kidney function, blood glucose, calciu
According to the differential diagnosis of 4.4.1 need detection of blood and urine routine, liver and kidney function, blood glucose, calcium, phosphorus, alkaline phosphatase, sex hormones and other items, such as 25 hydroxy vitamin D3 and l, 25 dihydroxyvitamin D3, parathyroid hormone.
4.4.2 according to the condition monitoring, drug selection and curative effect observation and the need for differential diagnosis, conditional units can be selected for bone metabolism and bone turnover indicators (including bone formation and bone resorption index). These markers may be useful in the classification of bone turnover, bone loss rate, risk assessment of fracture in elderly women, and selection and evaluation of disease progression and interventions. The reaction of bone formation markers: serum alkaline phosphatase (ALP), osteocalcin (OC), bone alkaline phosphatase (BALP), type I procollagen C end peptide (PICP) and N peptide (PINP). The reaction of bone resorption index: 2 hours of fasting urinary calcium / creatinine ratio, or plasma tartrate resistant acid phosphatase (TPACP) and type I collagen C terminal peptide (SCTX), urinary pyridinoline (Pyr) and deoxypyridinoline (dPyr), urinary type I collagen C terminal peptide (UCTX) and N terminal peptide (UNTX) etc..
5 problems should be considered in the diagnosis of osteoporosis
5.1 the main characteristics of primary osteoporosis is bone loss. Therefore, brittle fracture and bone mineral density measurement should be the most direct, the most clear and final means. Other methods, such as historical investigation and biochemical test, can only be used as auxiliary and differential diagnosis.
5.2 because of the bone fracture caused by osteoporosis is mostly compression fracture of lumbar vertebrae, femoral neck fracture and distal radius fracture, so the above three parts of the measurement site is appropriate. Three parts of the results of comprehensive analysis to make a diagnosis. The bone mineral density at the site of measurement is of greatest value in predicting the risk of fracture in this region, such as hip fracture risk.
5.3 effects of DXA bone density by bone tissue degeneration, injury, soft tissue changes and ectopic calcification composition and position difference would produce a certain degree of deviation, standard is also affected by the impact of the operation, the accuracy of the instrument. Therefore, the use of DXA to measure bone density should be strictly in accordance with the quality control requirements (refer to the international society for clinical bone density ISCD consensus opinion). The recommended clinical measurement sites are L1 to 4 and the femoral neck, and the diagnosis should be combined with clinical analysis.
6 differential diagnosis of primary osteoporosis
Diagnosis of primary osteoporosis is also required to exclude other bone metabolic diseases, including osteomalacia, osteomalacia, renal bone dystrophy, Paget disease, hyperparathyroidism and bone tumors. In addition to X-ray and bone mineral density measurement, bone metabolic biochemical markers are helpful in the differential diagnosis of osteoporosis.
Osteoporosis is also known as "soundless and stirless epidemic", early no obvious symptoms, much was discovered in a slight force caused after fracture. So far, only a variety of treatment methods we have so little Liang Zengcu, thickening of bone, the hole to be repaired, but can not make the trabecular bone fracture and connection, so the prevention of osteoporosis treatment, more realistic and more important. Moreover, osteoporosis can be prevented. Therefore, it is urgent to diagnose and take preventive measures as soon as possible.