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| 短期大剂量糖皮质激素治疗对骨转换指标、骨密度和骨小梁评分的影响 |
| Effects of short-term high-dose glucocorticoid therapy on bone turnover index, bone mineral density and trabecular bone score |
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| DOI：10.3969/j.issn.1006-7108.2021.01.017 |
| 中文关键词: 糖皮质激素 骨转换标志物 骨密度 |
| 英文关键词:glucocorticoid bone turnover markers bone mineral density |
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| 中文摘要: |
| 目的 观察短期使用大剂量糖皮质激素（glucocorticoid，GCs)对骨转换标志物、骨密度（bone mineral density，BMD)和骨小梁评分（trabecular bone scores，TBS)的影响。方法选取33例（女性19例，男性14例，平均年龄49岁）需要静脉注射（iv ) 甲基强的松治疗的活动性Graves’眼病患者。所有患者均给予中位累积剂量4.5 g (范围1.5~5.25 g) iv甲基强的松。分別于基线、1周和第1、3、6、12个月测定骨代谢生化指标（25羟维生素D、PTH、P1NP、CTX和BALP)。在基线、6个月和12个月时通过X射线吸收测量法（DXA)获得受试者BMD和TBS。结果 PTH、BALP、P1NP无明显变化。1个月时CTX显著下降 (比基线下降49.31%，P = 0. 02)，在3个月测量时恢复到基线。P1NP有改变（不显著），但持续下降。BMD或TBS无明显变化。结论 短期大剂量GCs治疗可快速、短暂地抑制骨吸收，对BMD或骨微结构（TBS)无影响。 |
| 英文摘要: |
| Objective To observe the effect of short-term, high-dose glucocorticoid (GCs) on bone turnover markers, bone mineral density (BMD)，and trabecular bone scores (TBS). Methods 33 patients (19 females and 14 male； median age 49 years) with active Graves，orbitopathy (GO) who were candidates for treatment with intravenous (iv) methylprednisone were consecutively enrolled. All patients were given a median cumulative dose of 4. 5 g (range 1. 5-5. 25 g) iv methylprednisone. Biochemical parameters of bone metabolism (25-hydroxyvitamin D，PTH, P1NP, CTX and BALP) were measured at the baseline, and then 1 week and 1,3, 6 and 12 months. BMD and TBS were obtained by X-ray absorptiometry (DXA) at the baseline and at 6 and 12 months. Results There were no significant changes in PTH, BALP or P1NP. A significant drop in CTX was seen at 1 month (down 49. 31% from the baseline, P = 0. 02)，with a return to the baseline at the 3-month measurement. There was a moderate (not significant)，but persistent reduction in P1NP. There was no significant change in BMD or TBS. Conclusion Short-term high-dose GCs treatment can quickly and transiently inhibit bone resorption without affecting BMD or bone microstructure (TBS). |
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