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及GIOP指南的培训、制作改善生活方式的传单、加强对 porosis:clinical audit to evaluate the implementation of
患者的用药教育以及每2个月进行一次重新评估,可使 national osteoporosis guideline group 2017 guidelines in a
[6]
患者的GIOP防治规范率由25%提高到92% 。另外,电 primary care setting[J]. J Clin Densitom,2019,22(1):
子健康记录系统同样发挥着重要作用,它可以发现系统 25-30.
性红斑狼疮患者骨质疏松发生的风险因素,进而提高 [ 7 ] 张学武,姚海红,梅轶芳,等. 全国多中心使用糖皮质激
[18]
GIOP 诊断和防治的规范性 。非三甲医院与三甲医院 素风湿病患者骨质疏松调查[J]. 中华临床免疫和变态反
应杂志,2017,11(3):277-284.
在医疗资源与信息化程度上存在差距,应加强对非三甲
[ 8 ] 纪宗斐,张卓君,鲍春德,等. 糖皮质激素相关骨质疏松
医院医生的 GIOP 防治的相关培训,完善电子健康记录
的流行病学调查[J]. 中华风湿病学杂志,2014,18(8):
系统,提高GIOP的诊疗水平。 520-524.
在患者层面,加强对吸烟或饮酒患者的关注,提高 [ 9 ] 何菁,李芬,黄文辉,等. 糖皮质激素性骨质疏松症的诊
其对 GIOP 防治药物的用药依从性;对于用药后出现不 疗规范[J]. 中华内科杂志,2023,62(6):631-638.
良反应的患者,停药后尽可能换用其他类型抗骨质疏松 [10] CHOTIYARNWONG P,MCCLOSKEY E V. Pathoge-
药物;对中、高度骨折风险的患者,应加强随访,定期复 nesis of glucocorticoid-induced osteoporosis and options
查和调整治疗方案,提高GIOP防治药物使用的规范性。 for treatment[J]. Nat Rev Endocrinol,2020,16(8):
3.5 本研究的局限性 437-447.
本研究仅对单家医院收治的长期使用糖皮质激素 [11] WANG L T,CHEN L R,CHEN K H. Hormone-related
患者的 GIOP 防治药物使用的规范性进行了研究,不能 and drug-induced osteoporosis:a cellular and molecular
全面反映目前国内GIOP防治药物规范使用的现状。 overview[J]. Int J Mol Sci,2023,24(6):5814.
[12] BILLUPS S J,THAI V K,DENKINS J,et al. Bad to the
4 结语
bones:prescribing of drugs for the prevention and treat‐
本研究依据2023《GIOP诊疗规范》对我院长期使用
ment of osteoporosis in patients on chronic glucocorticoids
糖皮质激素患者的 GIOP 防治药物使用情况进行分析,
[J]. Arch Osteoporos,2023,18(1):38.
结果显示,我院 GIOP 防治药物的使用规范率较低;中、
[13] IKI M,FUJIMORI K,NAKATOH S,et al. Real-world ef‐
高度骨折风险,吸烟或饮酒史,服用抗骨质疏松药物后 fectiveness of anti-osteoporosis medications for the pre‐
出现不良反应患者的防治规范率较低,而既往1个月就 vention of incident hip and clinical vertebral fractures in
诊三甲医院、使用糖皮质激素时间更长患者的防治规范 patients on long-term glucocorticoid therapy:a nationwide
率较高。建议可通过改进医保政策、设立GIOP门诊、加 health insurance claims database study in Japan[J]. Bone,
强对医务人员的培训及对患者的用药教育和随访等措 2023,166:116605.
施来提高GIOP防治药物使用的规范性。 [14] BJORNSDOTTIR H H,EINARSSON Ó B,GRÖNDAL
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中国药房 2025年第36卷第8期 China Pharmacy 2025 Vol. 36 No. 8 · 995 ·