糖皮质激素性骨质疏松症骨代谢与糖皮质激素用药时间的相关性

发布时间：2018-05-20 02:26

  本文选题：糖皮质激素性骨质疏松症 + 系统性红斑狼疮　； 参考：《山东大学学报(医学版)》2017年05期

【摘要】：目的观察骨代谢在糖皮质激素性骨质疏松症(GIOP)进展过程中与糖皮质激素用药时间的关系及变化规律,并依据骨代谢变化趋势探讨GIOP的防治策略。方法检测应用GC控制病情的系统红斑狼疮患者117例和健康人群21例骨代谢标志物(β-CTX、T-P1NT、N-MIDOs),测定L1-4椎体骨密度。依据GC使用时间将患者分为7个亚组:Ⅰ组用药1~6个月,Ⅱ组用药7~12个月,Ⅲ组用药13~18个月,Ⅳ组用药19~24个月,Ⅴ组用药25~30个月,Ⅵ组用药31~36个月,Ⅶ组用药36个月。结果Ⅰ组、Ⅱ组和Ⅲ组β-CTX较正常对照组明显升高,差异有统计学意义(P0.05);Ⅵ组和Ⅶ组β-CTX较正常对照组明显减低,差异有统计学意义(P0.05);Ⅳ组和Ⅴ组β-CTX较正常对照组无明显差异(P0.05);应用GC的各亚组T-P1NT、N-MIDOs均较正常对照组明显减低,差异有统计学意义(P0.05);Ⅱ~Ⅶ组骨密度较正常对照组明显减低,差异有统计学意义(P0.05)。结论 GIOP形成过程中,骨代谢是由高分解状态向低分解低成骨低转换状态转变。应用GC 1~18个月的SLE患者骨代谢状态处于高分解低成骨,应用GC 30个月以上的患者骨代谢状态处于低分解低成骨低转换状态。
[Abstract]:Objective to observe the relationship between bone metabolism and glucocorticoid administration time during the development of glucocorticoid-induced osteoporosis (GIOP) and discuss the prevention and treatment strategy of GIOP according to the trend of bone metabolism. Methods Bone mineral density (BMD) of L1-4 vertebrae was measured in 117 patients with systemic lupus erythematosus and 21 healthy controls. According to the time of GC, the patients were divided into seven subgroups: group 鈪，

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