摘要
目的了解原发性肾小球疾病患者糖皮质激素性骨质疏松的发病及预防治疗情况。方法记录应用糖皮质激素(GC)的原发性肾小球疾病患者的年龄、性别、体重指数、吸烟史、应用 GC的时间、累积剂量、骨质疏松预防治疗用药情况;测定腰椎和股骨颈骨密度。结果 123例病人中骨质异常(骨量减少和骨质疏松)者82例(66．7％),骨密度正常者41例(33．3％)。腰椎骨密度随GC的累积剂量的增加而逐渐下降,服用GC>1个月的各组与<1个月组相比腰椎骨密度下降明显(P<0．05),>12个月者与1-<3个月者相比腰椎骨密度下降显著(P<0．05)。只有43例患者能规律服用维生素D加钙剂,在服用GC累积剂量及时间无差异的条件下,规律服用维生素D 加钙剂组骨质异常发生率(34．9％)明显低于单纯服用钙剂组(78．2％)及不用药组(73．4％),P< 0．05。结论原发性肾小球疾病应用GC患者骨密度随GC的累积剂量增加而逐渐下降,GC的累积剂量及未预防应用维生素D及钙剂是骨密度下降的危险因素。
Objective To investigate the state of glucocorticold （GC） - induced osteoporosis （GIOP） and the current prevention of GIOP in patients with primary glomerulonephritis. Methods Primary glomerulonephritis patients receiving GC therapy were observed and bone mineral density （BMD） in the lumbar spine and the femoral neck were measured. Age, sex, body - mass - index, smoking history, the time and accumulative dose of GC treatment, and the state of osteoporosis prevention were investigated, the factors that influence the BMD were analyzed. Results A total of one hundred and twenty - three patients were included in this study. Among them, osteoporosis and osteopenia were found in 82 patients （66.7%）. Lumbar spine BMD decrease gradually with the increase of the accumulative dose of GC. There were statistical differences in the BMD of lumbar spine in patients with receving GC at the period of less than 1 month compared with other groups（ 1 - 〈 3, 3- 〈 6, 6-〈 9, 9- 〈 12, 〉 12 months） （ P 〈 0.05）. Among 123 patients, only 43 patients took vitamin D and agent containing calcium regularly, but the incidence of abnormal BMD in this group was significant de- creased compared with other only taking agent containing calcium and without treatment at the same state of CA2 treatment period and accumulative dose （P 〈 0.05）. Conclusion BMD in patients with primary glomerulonephritis receiving GC therapy decrease gradually with the incresse of accumulative dose of GC. Accumulative dose of GC and without receiving osteoporosis prevention therapy were risk factors of abnormality of BMD.
出处
《中国医师进修杂志（内科版）》
2006年第3期15-17,共3页
Chinese Journal of Postgraduates of Medicine
基金
北京大学"十五""211"工程-循证医学学科群课题项目(91000-246156061)
关键词
原发性肾小球疾病
糖皮质激素性骨质疏松
骨密度
Primary glomerulonephritis
Glucocorticoid -induced osteoporosis
Bone mineral density
