摘要
目的探讨糖皮质激素治疗对哮喘患者骨形成的影响.方法对短期(7 d)吸入二丙酸氯地米松7例(beclometha-sone,BDP 200μg tid,为二丙酸氯地米松组)或口服强的松8例(10～15 mg qd,为强的松组)的哮喘儿童(年龄11～14岁)以及非皮质激素治疗8例的哮喘儿童为对照组),吸入BDP 6例或口服皮质激素5例的成年哮喘患者(年龄20～40岁)以及非皮激素治疗5例哮喘成人患者对照组的血清骨钙素水平(osteocalcin)进行了自身对照研究.结果①在哮喘儿童中,治疗前3组患者骨钙素差异无显著性.吸入BDP(24.99±4.71)μg/L或口服强的松(18.46±4.84)μg/L 1周后,血清骨钙素水平均显著低于对照组[(30.41±6.79)μg/L,P＜0.05和P＜0.01].吸入BDP前后骨钙素的变化值显著低于口服强的松前后骨钙素的变化值(P＜0.01).②在哮喘成人中,治疗后仅强的松组骨钙素水平[(5.44±1.39)μg/L]显著低于非激素组[(7.05±3.53)μg/L,P＜0.01].但BDP组治疗前[(7.30±3.55 μg/L)]与后[(6.04±2.83)μg/L]血清骨钙素水平差异有显著性(P＜0.05).此外,还对长期(2个月)吸入小剂量BDP(200μg每日1次或2次)的患者进行了配对对照研究,发现吸入BDP 2个月后患者骨钙素[(28.54±5.24)μg/L]显著低于正常对照组[(33.33±4.24)μg/L,P＜0.05].结论提示吸入或口服治疗量的皮质激素可使骨钙素下降,有可能导致骨形成的抑制.但它的临床意义还有待进一步研究和探讨.
[ Objective] To investigate the effect of short term glucocorticoid therapy on the bone formation of the patients. [ Melhods] A 7 - day self- matched and randomized trial was carried out. 23 children patients with asthma were divide into 3 groups： 7 cases inhaled beclomethasene, 8 cases inhaled prednisene, and 8 cases that had received no glucocorticoid treatment were taken as the control group. 16 adult patients were divided into 3 groups： 5 cases inhaled beclomethasene, 6 cases inhaled glucocorticoid, and 6 cases received no glucocorticoid treatment were taken as the control group. [ Results] No significant difference was found in the Osteocalcin among the 3 children groups before treatment. After the glucocorticoid treatment, the level of serum Osteocalcin among the cases groups was significantly lower than that in the control group （P 〈 0.01） . Significant difference was found in the Osteocalcin among the 3 adult groups before treatment. After treatment, only the level of serum Osteocalcin in the prednisene group was significantly lower than that in the control group （ P 〈 0.01 ） . The study also indicated that the level of serum Osteocalcin in the group that inhale BDP for 2 months in small doses was significantly lower than that in the control group （ P 〈 0.05 ） . [ Conclusion] It is indicated that the inhalation of glucocorticoid may lead to the decrease of Osteocalcin and the restrain of bone formation of the patients.
出处
《职业与健康》
CAS
2005年第11期1685-1686,共2页
Occupation and Health
