營養(yǎng)與骨質(zhì)疏松癥

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10、wrulingganicunifiedupinsistedlawrulinglawrulinglawadministrativecommonadvanceinsistedruleoflawnationalruleoflawGovernmentruleoflawsocialoneconstructionfulladvancesciencelegislationstrictlylawenfcementjustjudicialuniversa

11、llawabidingChinafeaturessocialistlegalsystemfurthersoundperfectleadersatalllevelscadresusingruleoflawthinkingruleoflawwaydeepeningrefmpromoteddevelopmentTheabilitytoresolveconflictsconstantlyimproveour...6.onthebuildingo

12、fSocialistcultureinChina.AcountryanationstrongalwayssupptedbycultureflourishedtheinheritancedevelopmentofcivilizationwithoutculturetodevelopprospertherewillbenorealizationofthedreamofChina.18bigyilaiXIGeneralSecretaryaro

13、und“fosterpromoteSocialistcevalues““promoteChinaexcellenttraditionalculture““firmlymasterideologywkledrightdiscourseright“aspectsdohasseriesimptantspeechmainincludingputpublicitythoughtwkdohavebetterfachievedChinadreamco

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16、directlymostrealityofinterestsproblem3yearscumulativereductionpovertymethan50millionpeopleequivalenttoamediumnationalpopulationoftotalannualaddedtownemploymentmethan10millionpeoplestartsconstructionsupptabilityhousingeng

17、ineeringnear4millionsetsbuiltwldShangscalemaximumcoveruniversalofbasicmedicalguaranteeswkpensionguaranteeswkurbanruralresidentsincomecontinuedgrowthThelivesofthepeopleofallethnicgroupshavemeonbothmaterialspiritualthrivin

18、g.ThisaspectsXIGeneralSecretaryofspeechmainincludingpromotedpovertyareapovertyspeedupdevelopmentlet1.3billionpeopleenjoysbettermefairofeducationspeedupadvancehousingguaranteessupplysystemconstructionalwaysputpeoplelifese

19、curityputinfirstbitefftsputChinaconstructionbecamewkpowerinsistedgeneralnationalsecurityviewsgoChinafeaturesnationalsecurityroadeffectivemaintenancenationalsecuritysocialsettled.8.withregardtocomprehensivestrictlyadminis

20、teringtheparty.Partyof18bigyilaiCentralstationinpartynationalsurvivalofheightfirmlygraspstrengtheningpartyofrulingcapacityconstructionadvancedpurityconstructionthisarticlemainlinetostyleconstructionfbreakthroughtodevelop

21、edintroducedeightitemsprovidesstartedstartputdisciplinerulesisinfrontganizationcarriedouthaspartyofmasslineeducationpracticeactivities“threestrictthreereal“topiceducationinsisted“zerotolerancefullcovernoarea“insisted“Tig

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23、、一、骨量的獲得與丟失骨量的獲得與丟失1、骨的結(jié)構(gòu)與功能、骨的結(jié)構(gòu)與功能骨骼組織分為骨、軟骨以及附屬結(jié)構(gòu)。骨組織中其實(shí)細(xì)胞只占有2%5%，主要的我們知道是成骨細(xì)胞與破骨細(xì)胞，那么骨礦物質(zhì)呢約占到成年人骨干重的65%，其中鈣占到37%40%，其余的那主要的是磷能占到50%以上。骨礦物質(zhì)主要以羥基磷灰石結(jié)晶和無定形的磷酸鈣存在。那么骨的有機(jī)質(zhì)主要是骨膠原和那些沒有定型的磷酸鈣，骨的有機(jī)質(zhì)占到有機(jī)成分的90%，非膠原蛋白值約占到有機(jī)質(zhì)值的10

24、%左右。骨骼主要是由皮質(zhì)骨和小梁骨組成，皮質(zhì)骨能占到骨總量的80%，主要是在骨的外層，小梁骨又叫松質(zhì)骨，主要占到骨總量的20%。皮質(zhì)骨主要位于長骨的骨干，松質(zhì)骨主要位于脊椎呀、骨盆啊和骨的干骺端。說完松質(zhì)骨比皮質(zhì)骨的表面積要，松質(zhì)骨的骨表面積與骨量的比值大大的超過了皮質(zhì)骨，骨的重建呢主要是在骨的表面進(jìn)行，松質(zhì)骨的代謝的活性高于皮質(zhì)骨的10倍以上。2、鈣與激素調(diào)節(jié)、鈣與激素調(diào)節(jié)骨是體內(nèi)鈣和磷的儲(chǔ)存庫，成年人群中的鈣重量能達(dá)到1公斤到1.5

25、公斤，其中99%以上儲(chǔ)存在骨骼和牙齒中。與骨代謝有關(guān)的激素主要有甲狀旁腺激素，我們簡稱PTH，還有降鈣素簡稱CT。以及雌激素，那么雌激素只是針對女性而言的。那么皮膚中的維生素D的形成源于陽光中的紫外線照射，維生素D有助于鈣的吸收的。3、鈣的調(diào)整過程、鈣的調(diào)整過程當(dāng)血鈣濃度降低的時(shí)候，甲狀旁腺激素以及維生素D的水平就會(huì)增高，促使那個(gè)鈣在腸道內(nèi)的吸收增加，那么鈣排出就減少，腎臟里尿鈣的排泄也會(huì)減少，那么就是造成骨鈣丟失。反之，當(dāng)血鈣濃度增高

26、的時(shí)候，甲狀旁腺激素和維生素D的水平會(huì)下降，那么呢鈣的它的排出就會(huì)增加，它的吸收就會(huì)減少，尿鈣的排出也會(huì)增加，骨鈣就會(huì)沉積在骨頭骨骼里面。4、骨重建、骨重建人體的骨的新陳代謝是非常非?；钴S的，人的一生中骨重建都在不斷地進(jìn)行著，因?yàn)楣侵亟ǖ闹芷谀?，它持續(xù)兩到三個(gè)月，那么人老了時(shí)候呢，它的這個(gè)周期就要延長可以達(dá)到半年，那么這個(gè)骨重建的過程呢，主要是成骨細(xì)胞不斷的形成骨和破骨細(xì)胞不斷地引起骨頭吸收的一種動(dòng)態(tài)平衡的狀態(tài)下進(jìn)行的。5、鈣的儲(chǔ)備和骨

27、量、鈣的儲(chǔ)備和骨量一個(gè)人剛生下來的時(shí)候新生兒的含鈣量是25~30克左右，那么以后的20年中呢？它平均每天要儲(chǔ)集150毫克的鈣，到了20歲的時(shí)候他才能達(dá)到1公斤到1.2公斤的鈣儲(chǔ)備量，所以呢人在青春期的時(shí)候呢，人體對鈣的需求量是最高的。據(jù)報(bào)道，男孩子在14.2歲女孩子在12歲半的時(shí)候骨量增長是人生中最快的一個(gè)階段。骨的縱向生長停止就是這個(gè)人不再長高以后呢，它的骨的礦化還是在不斷地進(jìn)行著，其后的10~15年呢是骨的一個(gè)的加固階段，那么骨量還

28、要增長5~10%，以達(dá)到骨的峰值。李寧華等根據(jù)我們中國2300人的調(diào)查結(jié)果報(bào)告呢，男性的腰椎和股骨盡端，也就是股骨頭它的骨密度峰值出現(xiàn)在20~29歲組，女性腰椎峰值的骨密度出現(xiàn)在30~39歲組，那么股骨頭峰值出現(xiàn)在20~29歲組，也就是說女性的腰椎骨密度峰值呀出現(xiàn)時(shí)間要稍晚于，要晚于男性，那么女性到了絕經(jīng)期的時(shí)候，它的雌激素分泌下降，雌激素分泌下降的結(jié)果就會(huì)導(dǎo)致骨的丟失加速，腰椎的骨密度在40~49歲的時(shí)候呢就會(huì)有緩慢的下降，到了50~

29、59歲的時(shí)候呢就加速的下降，其他部位的骨密度的減少，比其他部位還要提早10年，那么男性和女性不同，他各個(gè)部位的骨密度都是從30到39歲以后，就逐漸的下降，那么不同的是沒有明確的丟失期。綜上所述，骨質(zhì)疏松的發(fā)生與年輕時(shí)峰值骨密度的高低和年老時(shí)骨丟失的速率關(guān)系很密切，兩者都受遺傳基因、營養(yǎng)狀況，運(yùn)動(dòng)負(fù)荷以及激素調(diào)控的影響。二、骨質(zhì)疏松的分類與臨床表現(xiàn)二、骨質(zhì)疏松的分類與臨床表現(xiàn)refmresultseconomypoliticalsyste

30、mculturesystemsocialsystemdisciplinechecksystempartyofconstructionsystemrefmsolidadvancetaxfinancialpriceadministrativeapprovalStateownedenterprisesecologicalcivilizationimptantfieldkeylinkrefmmademajprogressmarketinreso

31、urcesconfigurationintheofdecisiverolesignificantlyenhancedUnprecedentedburstofmomentumvitalityofeconomicsocialdevelopment.XIGeneralSecretarysspeechinthisregardincludetherefmonlywhenthereisnocompletethenotesonthe18session

32、ofideasintothepartysspiritoftherefmsmedifficulttomovefwardtheincreasinguseoftheSocialistsystemwithChineseacteristicssuchastheabilitytorunthecountry.4.withregardtopromotingsustainedhealthyeconomicdevelopment.Facecomplexch

33、angeableofinternationalsituationdifficultheavyofdomesticrefmdevelopmentstabletaskXIGeneralSecretarymadeChinaeconomicdevelopmentintonewnmalofsciencejudgeproposedinnovationcodinationgreenopensharedfivebigdevelopmentconcept

34、implementationmacropolicytostabilityindustrypolicytoassociatemicropolicytoliverefmpolicytorealsocialpolicytobackingfivebigpillarsexpolicyvigouslyadvancesupplysidestructuralrefmnewconceptachievedhas2013to2015duringDomesti

35、cproductiontotalannualgrowth7.3%obviouslyfastYuearlierwldeconomic2.3%ofannualgrowthonwldeconomicgrowthofcontributionover25%tertiaryindustryaccountedfdomesticproductiontotalshareover50%eventuallyconsumptiononeconomicgrowt

36、hofcontributionratereached66%economicstructureadjustmentmadeimptantprogressdevelopmentofqualitybenefitssignificantlyupgradeChinaeconomicshowouthugeofswingroombroadofdevelopmentprospects.ThisaspectsXIGeneralSecretaryofspe

37、echmainincludingeconomicgrowthmustisrealnowaterofgrowthimproveopentypeeconomiclevel“seemissingofh““seehaveseeofh“aretowithgoodspeedupfromelementsdriveinvestmentscaledrivedevelopmentmainlytotoinnovationdrivedevelopmentmai

38、nlyofchangeactivepromotedChinaenergyproductionconsumptionrevolution.5.withregardtobuildingtheruleoflawinChina.18bigyilaiCentraltightlyaroundfulladvancelawrulingputpartyofledpeoplemasterslawrulingganicunifiedupinsistedlaw

39、rulinglawrulinglawadministrativecommonadvanceinsistedruleoflawnationalruleoflawGovernmentruleoflawsocialoneconstructionfulladvancesciencelegislationstrictlylawenfcementjustjudicialuniversallawabidingChinafeaturessocialis

40、tlegalsystemfurthersoundperfectleadersatalllevelscadresusingruleoflawthinkingruleoflawwaydeepeningrefmpromoteddevelopmentTheabilitytoresolveconflictsconstantlyimproveour...6.onthebuildingofSocialistcultureinChina.Acountr

41、yanationstrongalwayssupptedbycultureflourishedtheinheritancedevelopmentofcivilizationwithoutculturetodevelopprospertherewillbenorealizationofthedreamofChina.18bigyilaiXIGeneralSecretaryaround“fosterpromoteSocialistcevalu

42、es““promoteChinaexcellenttraditionalculture““firmlymasterideologywkledrightdiscourseright“aspectsdohasseriesimptantspeechmainincludingputpublicitythoughtwkdohavebetterfachievedChinadreamcondensedpowerfulmalsupptimprovena

43、tionalculturesoftstrengthfosterpromoteSocialistcevaluesyouthtoconsciouslypracticelineSocialistcevaluesChildhoodactivelycultivatepracticethecevaluesofsocialismthepartysimptantspeechonthepressconference.7.promotetherefmdev

44、elopmentofsocialundertakingssocialmanagement.18bigyilaiCentralinsistedputguaranteesimprovedlivelihoodasrulingactingpoliticalofstartingpointfootholdXiabigpneumaticsolutionmassesmostcaremostdirectlymostrealityofinterestspr

45、oblem3yearscumulativereductionpovertymethan50millionpeopleequivalenttoamediumnationalpopulationoftotalannualaddedtownemploymentmethan10millionpeoplestartsconstructionsupptabilityhousingengineeringnear4millionsetsbuiltwld

46、ShangscalemaximumcoveruniversalofbasicmedicalguaranteeswkpensionguaranteeswkurbanruralresidentsincomecontinuedgrowthThelivesofthepeopleofallethnicgroupshavemeonbothmaterialspiritualthriving.ThisaspectsXIGeneralSecretaryo

47、fspeechmainincludingpromotedpovertyareapovertyspeedupdevelopmentlet1.3billionpeopleenjoysbettermefairofeducationspeedupadvancehousingguaranteessupplysystemconstructionalwaysputpeoplelifesecurityputinfirstbitefftsputChina

48、constructionbecamewkpowerinsistedgeneralnationalsecurityviewsgoChinafeaturesnationalsecurityroadeffectivemaintenancenationalsecuritysocialsettled.8.withregardtocomprehensivestrictlyadministeringtheparty.Partyof18bigyilai

49、Centralstationinpartynationalsurvivalofheightfirmlygraspstrengtheningpartyofrulingcapacityconstructionadvancedpurityconstructionthisarticlemainlinetostyleconstructionfbreakthroughtodevelopedintroducedeightitemsprovidesst

50、artedstartputdisciplinerulesisinfrontganizationcarriedouthaspartyofmasslineeducationpracticeactivities“threestrictthreereal“topiceducationinsisted“zerotolerancefullcovernoarea“insisted“Tiger““flies“withplayingstylepoliti

51、calwindsocietycontinuedimprovedMeperfectsystemoflawswithinthepartydisciplineofauthitativeseriousnessincreasingfthehistyofwinninghasalotofnewfeaturesprovideastrongpolitical（3）WHOWHO對骨質(zhì)疏松癥的診斷標(biāo)準(zhǔn)對骨質(zhì)疏松癥的診斷標(biāo)準(zhǔn)衛(wèi)生組織對骨質(zhì)疏松癥制訂了一個(gè)診斷的

52、標(biāo)準(zhǔn)，測量骨密度就是診斷骨質(zhì)疏松的金標(biāo)準(zhǔn)。當(dāng)老人的骨密度，低于正常青年組的1個(gè)到2.5個(gè)標(biāo)準(zhǔn)差時(shí)，那么我們叫做他骨量減少；如果他低于年輕人的骨量的2.5個(gè)標(biāo)準(zhǔn)差，就可以診斷為骨質(zhì)疏松癥，骨質(zhì)疏松癥，如果伴有骨折，它就會(huì)稱為嚴(yán)重的骨質(zhì)疏松癥。大量的研究也證實(shí)呢，骨密度能夠準(zhǔn)確地預(yù)測絕經(jīng)后婦女發(fā)生骨折的危險(xiǎn)性。它與測血壓預(yù)測中風(fēng)一樣的可靠，而且比測血脂，比方說測膽固醇呢，來預(yù)測冠心病還要優(yōu)越。那么骨密度每低于年齡校準(zhǔn)基數(shù)一個(gè)標(biāo)準(zhǔn)差，髖部骨折

53、的危險(xiǎn)性就會(huì)上升到一倍。（4）骨質(zhì)疏松癥是遺傳性疾?。┕琴|(zhì)疏松癥是遺傳性疾病骨質(zhì)疏松是一種遺傳病，是一種多基因疾病，它與維生素D受體基因，雌激素受體基因1型膠原基因等都有關(guān)系。它也是一個(gè)多因素引起的疾病，它是一個(gè)復(fù)雜性的疾病，他通過遺傳環(huán)境相互作用引起。對人類的健康造成如此大的影響，醫(yī)學(xué)界已經(jīng)將它放在非常重要的位置，那么防治骨質(zhì)疏松癥預(yù)防骨折跟治療高血脂預(yù)防心肌梗塞，治療高血壓預(yù)防中風(fēng)一樣重要。（5）骨質(zhì)疏松癥的危險(xiǎn)因素）骨質(zhì)疏松癥的危

54、險(xiǎn)因素有好多的因素是我們不可能改變的，比方說年齡的更改，絕經(jīng)，種族，再有一些藥物的影響是不可以改變的，但是我們可以改變其中的一些危險(xiǎn)因素，降低它的危險(xiǎn)因素，預(yù)防骨質(zhì)疏松。三、營養(yǎng)素與骨質(zhì)疏松癥的關(guān)系三、營養(yǎng)素與骨質(zhì)疏松癥的關(guān)系1、鈣與骨質(zhì)疏松癥的關(guān)系、鈣與骨質(zhì)疏松癥的關(guān)系Ndin在二十世紀(jì)四十年代才提出缺鈣是骨質(zhì)疏松癥的病因，然后Matkoyic在七十年代的南斯拉夫人群實(shí)驗(yàn)中證實(shí)了這一點(diǎn)。動(dòng)物實(shí)驗(yàn)中很清楚地觀察到喂飼低鈣飼料的動(dòng)物其骨長

55、度、骨重量與骨密度均顯著低于喂飼一般常備飼料者，且其骨骼很容易骨折。鈣缺乏引起骨質(zhì)疏松的機(jī)制：低鈣生物可能使血鈣有所降低，那么繼續(xù)性的甲狀旁腺激素分泌增加，甲狀旁腺激素升高，骨吸收就增強(qiáng)，那么骨鈣被進(jìn)入血液，以保持血鈣的正常，那么骨頭里面的鈣就越來越少，最終就導(dǎo)致骨質(zhì)疏松，還有一個(gè)是細(xì)胞，細(xì)胞外的鈣離子的濃度增高，抑制破骨細(xì)胞的功能，那么導(dǎo)致破骨細(xì)胞收縮，并導(dǎo)致凋亡，骨吸收明顯下降，同時(shí)，成骨細(xì)胞膜上有鈣片的假感受器，細(xì)胞外液鈣離子濃度