邢晗　　张雨婷　　刘艳　　丁康　　张苏闽

[摘要] 骨质疏松症（OP）是炎症性肠病（IBD）的一种肠外并发症，因其较低的筛查率和隐匿的临床症状而常被人所忽视。据报道，IBD骨质疏松患者出现骨折的风险较高，对其疾病的转归、正常生活与工作产生了巨大的影响。近年来，IBD相关骨质疏松在病因、诊断与治疗上均取得了许多进展。本文就IBD相关骨质疏松的常见病因、诊断及治疗方法作一综述，希望以此提高对此病的认知与重视，并为临床工作者对其做出相应的诊治与处理提供一定的帮助。

[关键词] 炎症性肠病;骨质疏松;骨密度;维生素D

[中图分类号] R574          [文献标识码] A          [文章编号] 1673-9701（2021）12-0187-06

Progress in diagnosis and treatment of osteoporosis associated with inflammatory bowel disease

XING Han1   ZHANG Yuting1   LIU Yan1   DING Kang2   ZHANG Sumin2

1.Nanjing University of Chinese Medicine， Nanjing   210029， China; 2.Department of Proctology， Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine， Nanjing   210029， China

[Abstract] Osteoporosis（OP） is an extraintestinal complication of inflammatory bowel disease（IBD）. It is often overlooked because of its low screening rate and hidden clinical symptoms. According to reports， patients with IBD and osteoporosis have a higher risk of fracture，which exerts a huge impact on the outcome of their disease，their normal life and work. In recent years，many advances have been made in the etiology，diagnosis and treatment of IBD-related osteoporosis. This article summarizes the common causes，diagnosis and treatment of IBD-related osteoporosis，hoping to increase the awareness and attention for this disease，and provide some clues for clinicians in the diagnosis and treatment.

[Key words] Inflammatory bowel disease; Osteoporosis; Bone mineral density; Vitamin D

炎症性肠病（Inflammatory bowel disease，IBD）是一种病变可累及全消化道的慢性非特异性炎症性疾病，包括溃疡性结肠炎（Ulcerative colitis，UC）和克罗恩病（Crohn′s disease，CD），具体病因尚不明确，一般认为可能与遗传、免疫、环境、感染、肠道菌群等因素的综合作用有关。目前使用的治疗药物包括5-氨基水杨酸（5-ASA）、糖皮质激素、微生态制剂、免疫抑制剂与生物制剂等。IBD病程漫长、病情迁延反复，在疾病发展阶段可出现多系统与器官受累并发生多种肠外并发症，骨质疏松症即是其中较为常见的一种。

骨质疏松症（Osteoporosis，OP）是一种以骨密度降低、骨组织微结构损坏导致骨脆性增加、容易发生骨折为特征的代谢性疾病[1]，临床症状一般表现为乏力、局部或全身性骨痛、受累处变形及易出现骨折等。据报道显示[2]，IBD患者骨質疏松的确诊率为18%～42%，由于疾病初期临床症状较为隐匿及筛查率低下，其真实患病率应该更高。……