| 长期使用甾体类药物治疗类风湿...
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http://www.oowoo.net 2005年7月19日9:33
J Rheumatol |
期刊名称：J Rheumatol
英文题目：Effect of calcitriol on bone mineral density in premenopausal Chinese women taking chronic steroid therapy. A randomized, double blind, placebo controlled study.
中文题目：长期使用甾体类药物治疗的绝经期前中国女性中骨化醇对骨密度的影响。一个随机，双盲，安慰剂对照研究
文章来源：2000-7 ；27卷；1759-65页
作者：Lambrinoudaki I 、 Chan DT、Kung AW
英文摘要：
OBJECTIVE: To study the effect of chronic steroid therapy on bone mineral density (BMD) in premenopausal women with normal menstrual cycles and its treatment. METHODS: A double blind placebo controlled study to evaluate 81 premenopausal women with systemic lupus erythematosus (SLE), aged 31.1 6 years, taking chronic steroid therapy, with a mean cumulative prednisone dose of 28 16.2 g. They were randomly allocated to 3 groups: Group 1: 0.5 microg calcitriol and 1200 mg calcium daily; Group 2: 1,200 mg calcium and placebo calcitriol; and Group 3: both placebo calcitriol and placebo calcium. RESULTS: Baseline T score at the lumbar spine was > -1 in 56.8% and < -2.5 in 3.7% of the patients. At the end of 2 years, patients in the calcitriol group exhibited a significant increase of 2.1 2.4% in BMD at the lumbar spine compared to baseline value (p < 0.05). This change was not significantly different from the respective change in either calcium or placebo group (0.4 2.9% and 0.3 3.5%, respectively). No significant changes were observed in any treatment group in BMD at the hip or radius. Alkaline phosphatase increased both in the placebo (baseline: 57.5 17.5 IU/I; year 2: 60.9 15.3 IU/A) and the calcium group (baseline: 53.6 16.6 IU/I; year 2: 59.0 22.8 IU/1), but this increase reached statistical significance only in the calcium group, while the same variable remained stable in the calcitriol group (baseline: 53.9 14.1 IU/I; year 2: 54.6 12.3 IU/I). CONCLUSION: Premenopausal women with SLE taking prolonged steroid therapy had lower BMD but showed no significant bone loss over the 2 year study period. The beneficial effect of calcitriol treatment in these premenopausal women was small, at least when it was instituted late in the course of steroid therapy.
中文摘要：
目 的：研究长期类固醇药物治疗对具有正常月经周期的绝经期前妇女骨密度（BMD）的影响。方 法：以双盲安慰剂对照研究评价81名平均年龄31.1岁，患系统性红斑狼疮（SLE）的绝经期前妇女共6年，长期服用类固醇类药物，平均累积强的松剂量16.2g。她们被随机分配到3个组：1组：每日0.5微克1;25-二羟胆骨化醇和1200毫克钙剂，2组：1200毫克钙剂和1;25-二羟胆骨化醇安慰剂，3组：钙剂和1;25-二羟胆骨化醇都是安慰剂。结 果：患者中腰椎基线T评分56.8%> -1，3.7%< -2.5。两年后，在1;25-二羟胆骨化醇组的病人表现出腰椎骨密度明显增加2.1- 2.4%，与基线相比p < 0.05。而在钙剂组和安慰剂组没有明显的变化(分别是0.4 2.9% 和 0.3 3.5%)。在各组总都未观察到髋和桡骨骨密度的明显变化。 碱性磷酸酶在安慰剂组(基线: 57.5 17.5 IU/I;第二年: 60.9 15.3 IU/A)和钙剂组(基线: 53.9 14.1 IU/I;第二年: 54.6 12.3 IU/I)都有增长。结 论：患SLE的绝经期前妇女长期服用类固醇类药物治疗会有骨密度减低，但是在两年的研究期间未发现明显骨丢失。1;25-二羟胆骨化醇治疗在绝经期前妇女中的有利作用较小，至少在类固醇药物治疗后期使用是如此。
英文关键词：calcitriolbone mineral densitysteroid therapypremenopausal
中文关键词：125-二羟胆骨化醇骨密度类固醇类药物治疗绝经期前
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