摘要
目的:探讨儿童激素性股骨头坏死的高危因素及预防儿童激素性股骨头坏死的药学干预措施。方法:回顾分析1例长期大剂量使用糖皮质激素(GC)引发股骨头坏死的病例,通过查阅文献对患者的年龄、性别、激素使用剂量、基因多态性等因素进行分析,探讨患儿发生激素性股骨头坏死的高危因素以及预防儿童激素性股骨头坏死的药学干预措施。结果:年龄>10岁、每日使用大剂量激素治疗、接受激素冲击治疗是发生激素性股骨头坏死的高危因素。基因多态性与激素性股骨头坏死的相关性研究仍缺乏定论。为减少激素性股骨头坏死的发生,对于存在高危因素的患者应注意进行钙剂和维生素D的补充,必要时可考虑联用双磷酸盐预防治疗,但应注意进行相关的评估和用药监测。结论:年龄和糖皮质激素使用剂量是儿童激素性股骨头坏死的高危因素,对于存在高危因素的患者,应注意钙剂、维生素D以及双磷酸盐的补充。
Objective: To probe into the high risk factors for steroid-induced avascular necrosis of femoral head in children and pharmaceutical intervention measures for prevention of steroid-induced avascular necrosis of femoral head in children. Methods: A case of long-term high-dose glucocorticoid(GC)-induced avascular necrosis of femoral head was retrospectively analyzed. The age, gender, daily dose of glucocorticoid, genetic polymorphism were analyzed by retrieving the literature to explore the high risk factors for steroid-induced avascular necrosis of femoral head in children and pharmaceutical intervention measures for prevention. Results: Age >10 years, high daily dose of glucocorticoid, and glucocorticoid pulse therapy were high risk factors for steroid-induced avascular necrosis of femoral head. Correlation between gene polymorphism and steroid-induced avascular necrosis of femoral head was still inconclusive. In order to reduce the incidence of steroid-induced avascular necrosis of femoral head, patients with high risk factors should be supplemented with calcium and vitamin D, if necessary, bisphosphonate prophylaxis were supposed to be considered. However, attention should be paid to relevant assessment and medication monitoring. Conclusion: Age and daily dose of glucocorticoid are high risk factors for steroid-induced avascular necrosis of femoral head in children. For patients with high risk factors, calcium, vitamin D and bisphosphonate supplementation are necessary.
作者
李贝贝
姜志虎
孙华君
李志玲
刘红霞
Li Beibei;Jiang Zhihu;Sun Huajun;Li Zhiling;Liu Hongxia(Shanghai Children's Hospital,Children's Hospital of Shanghai Jiao Tong University,Shanghai 200062,China;Xiangyang No.1 People's Hospital,Hubei University of Medicine,Hubei Xiangyang 441000,China)
出处
《儿科药学杂志》
CAS
2022年第4期15-18,共4页
Journal of Pediatric Pharmacy
关键词
糖皮质激素
股骨头坏死
高危因素
儿童
glucocorticoid
avascular necrosis of femoral head
high risk factors
children
