|
| 糖皮质激素对狼疮性肾炎患者骨密度影响的临床研究 |
| Clinical study of the effect of glucocorticoids on bone mineral density in patients with lupus nephritis |
| |
| DOI： |
| 中文关键词: 狼疮性肾炎 糖皮质激素 骨质疏松 |
| 英文关键词:Lupus nephritis Glucocorticoids Osteoporosis |
| 基金项目: |
|
| 摘要点击次数: 834 |
| 全文下载次数: 912 |
| 中文摘要: |
| 目的观察狼疮性肾炎(LN)患者使用糖皮质激素(GC)治疗后的骨密度变化情况，探讨LN患者骨质疏松症的预防措 施。方法以初次诊断为LN并使用GC治疗半年以上的患者为研究对象，与使用GC治疗前相对照。使用GC治疗过程中按 照美国风湿病协会(ACR)指南建议给予骨质疏松症的预防治疗，每6月监测骨密度。结果人组患者共82例，其中女性74 例，男性8例，年龄14-72岁，平均（35. 8 ±14 5)岁，使用GC(7.5-63.4)月，平均（30. 3 ± 18. 0)月，累积使用GC剂量（8.5- 32. 5)g，平均（18. 6 ±6. 8)g。GC治疗过程中骨量减少及骨质疏松的发生率分别为20. 73%和10. 98%，均显著高于治疗前(P <0.05)；GC治疗过程中腰椎及股骨颈骨密度均显著低于治疗前(P <0.05)，随着使用GC时间的延长以及累积剂量的增加， 骨密度呈递减趋势;GC的累积剂量是骨质疏松的危险因素。结论LN患者应长期定期进行骨密度检测以评估骨骼健康状 况，同时对预防和治疗等干预进行评估，以预防骨质疏松的发生。 |
| 英文摘要: |
| Objective To investigate the changes of bone mineral density ( BMD) in patients with lupus nephritis during glucocorticoids (GC) therapy，and to explore the prevention methods of osteoporosis (OP) in such patients. Methods Patients who were diagnosed as lupus nephritis for the first time and had been treated with GC for at least 6 months were selected. Their clinical data were observed and compared with that before GC treatment. During the GC treatment， all patients were also given preventive treatments of osteoporosis according to American College of Rheumatology 2001 Recommendation. BMD of the lumbar vertebrae and the femoral neck was detected every 6 months. Results A total of 82 patients，including 74 females and 8 males， aging from 14 to 72 years old， with an average age of 35.8 ±14.5 years old， were included in this study. The duration of GC treatment ranged from 7.5 to 63.4 months， with an average of 30.3 ±18.0 months， and the accumulative dose of GC ranged from 8.5 to 32.5 g， with an average of 18.6 ±6.8 g. Among them， osteopenia and osteoporosis were found in 20.73% and 10.98% patients，respectively，which were both higher than those before GC treatment (P < 0. 05). BMD of the lumbar vertebrae and the femoral neck decreased along with the increase of duration and accumulative dose of GC (P < 0. 05). Accumulation of GC was a risk factor of osteoporosis. Conclusion Long-term and regular detection of BMD in patients with LN should be performed in order to evaluate bone health status， and the evaluation of the preventative and therapeutic strategies should be performed simultaneously to prevent osteoporosis. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |