摘要
目的:观察系统性红斑狼疮(SLE)经长期泼尼松治疗后骨密度及骨代谢生化指标的变化。方法:研究对象为生育年龄女性,SLE组(A组)26例(肾功能正常),于泼尼松治疗前、治疗后3个月、6个月分别用双能X线骨密度仪测定相关部位骨密度,同时测定空腹血钙、磷、碱性磷酸酶、甲状旁腺激素(PTH)、骨钙素(BGP)等生化指标。健康对照组(B组)20例。结果:(1)SLE组治疗前各部分骨密度与对照组差异无显著性(P>0.05)。泼尼松治疗后3个月骨密度除桡骨远端外无明显变化,治疗6个月时腰椎骨密度较治疗前下降(P<0.01)。(2)患者治疗后3、6个月血钙、磷、碱性磷酸酶无明显变化,血PTH均较治疗前上升(P<0.01),血BGP较治疗前下降(P<0.01)。结论:(1)系统性红斑狼疮长期泼尼松治疗后桡骨远端骨密度较早发生改变,腰椎次之。(2)泼尼松治疗后血BGP下降、PTH上升,血BGP和PTH是反映继发性骨量减少的敏感性生化指标,较骨形态学改变早。
Objective To explore the changes of the bone density and metabolic makers in patients with systemic lupus erythematosus（SLE） after long-time prednisone treatment. Methods All subjects were women. The healthy controls （group B, 20 cases）, the SLE patients with normal renal function （group A, 26 cases） were studied before and 3 and 6 months after prednisone treatment. Dual energy X-ray absorptiometry was used to measure bone mineral density （BMD）in the lumbar spine at L2 - L4 femoral neck, Ward＇s triangle, great trochanter （GT） and ultradis （ULT） . Simultaneously, the serum calcium, phosphate, alkalinephosphateenzyme, PTH, BGP, 24-hour urine hop and creatlnine were examined in all of them. Results （1）There were no significant differences in BMD between both groups before treatment （ P 〉 0.05）. The BMD showed no marked changes after 3 months glucocorticoid treatment except at ULT. The BMD of ULT and L2 - L4 was lower after 6 months glucocorticoid treatment than before it （ P 〈 0.01 ）. （2）Tbere were no changes in the serum calcium, phosphate and alkaline phosphate enzyme among them. The BGP was lower and PTH was higher after 3 and 6 months treatment than before it. Conclusion （ 1 ） The BMD decreases in SLE patients after long-tlme prednisone treatment. The changes of the BMD in ULT are earlier. （2）Serum BGP and PTH are sensitive markers for monitoring secondary bone loss. Their changes are earlier than bone morphological changes.
出处
《实用医学杂志》
CAS
2005年第23期2633-2635,共3页
The Journal of Practical Medicine
关键词
红斑狼疮
系统性
泼尼松
骨密度
Lupus erythematosus, systemic
Prednisone
Bone density
