Статья
Остеопороз и антитромботическая терапия
Антикоагулянтные и антитромбоцитарные препараты применяются для профилактики инсульта, тромбоэмболических осложнений. Недостаточно данных о влиянии на костную ткань этих препаратов, а имеющиеся данные неоднозначны, что повышает настороженность при применении их у лиц с риском развития остеопороза. В статье приводятся данные по действию антикоагулянтных и антитромбоцитарных препаратов на метаболизм кости, минеральную плотность костной ткани и риск переломов. Данные литературы свидетельствуют об отрицательном эффекте гепарина на костную ткань, заключающемся в увеличении риска переломов. Низкомолекулярные гепарины более нейтральны в отношении действия на костную ткань в сравнении с гепарином. Известно, что антагонисты витамина К существенно влияют на метаболизм костной ткани и маркеры костеобразования, однако данные о влиянии на минеральную плотность кости и риск переломов противоречивы. Относительно безопасны в отношении костной ткани новые прямые оральные антикоагулянты. Данные о влиянии антитромбоцитарных препаратов на кость неоднозначны.
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