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Менопаузальный остеопороз в практике врача-гинеколога

https://doi.org/10.21518/2079-701X-2021-12-320-331

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Аннотация

Остеопороз представляет серьезную проблему здравоохранения ввиду повышения риска низкотравматичных переломов, существенно снижающих качество жизни, сокращающих ее продолжительность и ложащихся тяжелым бременем как на социальное окружение пациентов, так и на общество в целом. Предотвращение остеопоротических переломов невозможно без ранней диагностики снижения минеральной плотности кости у лиц, входящих в группу риска. К сожалению, программа диспансеризации в популяции риска остеопороза не выполняется в реальной практике, и одним из вариантов решения этой задачи предлагается привлечение врачей разных специальностей к осуществлению профилактики и терапии этого заболевания. Поскольку риск остеопороза ассоциирован с возрастом и у женщин с эстрогенным дефицитом, врач-гинеколог может и должен брать на себя ответственность за формирование групп риска, наблюдение и своевременные рекомендации профилактических и лечебных мероприятий. Возможности врача-гинеколога не следует ограничивать исключительно рекомендациями по коррекции образа жизни и назначением менопаузальной гормональной терапии. Антирезорбтивные средства первой линии терапии остеопороза также могут входить в арсенал лечебных средств гинеколога. Среди них наиболее часто используются бисфосфонаты, обладающие хорошим профилем эффективности и безопасности при долговременном приеме. Оральный прием бисфосфонатов, однако, связан с низкой приверженностью лечению ввиду побочных реакций и необходимостью строгого соблюдения правил приема. Внутривенное введение бисфосфонатов, напротив, повышает комплаенс и позволяет обеспечить оптимальный результат терапии. Одной из возможностей применения парентеральной терапии бисфосфонатами в практике гинеколога является ибандронат, предназначенный для внутривенного струйного введения в режиме один раз в три недели на протяжении 5 лет. 

Об авторах

И. В. Кузнецова
Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова
Россия

д.м.н., профессор, советник директора, 

117997, Москва, ул. Академика Опарина, д.  4



Р. А. Чилова
Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)
Россия

д.м.н., доцент, профессор кафедры акушерства и гинекологии № 1 Института клинической медицины имени Н.В. Склифосовского, 

119991, Москва, ул. Трубецкая, д. 8, стр. 2



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Для цитирования:


Кузнецова И.В., Чилова Р.А. Менопаузальный остеопороз в практике врача-гинеколога. Медицинский Совет. 2021;(12):320-331. https://doi.org/10.21518/2079-701X-2021-12-320-331

For citation:


Kuznetsova I.V., Chilova R.A. Menopausal osteoporosis in the practice of a gynecologist. Meditsinskiy sovet = Medical Council. 2021;(12):320-331. (In Russ.) https://doi.org/10.21518/2079-701X-2021-12-320-331

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