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大剂量糖皮质激素对SARS患者骨代谢的影响
Hits: 1936   Download times: 1414   Received:August 01, 2003    
作者Author单位UnitE-Mail
崔全起 CUI Quan-qi 中国中医研究院广安门医院,北京100053 Guanganmen Hospital,China Academy of TCM cqqmd@sohu.com 
谢利民 XIE Li-min 中国中医研究院广安门医院,北京100053 Guanganmen Hospital,China Academy of TCM  
期刊信息:《中国骨伤》2004年17卷,第2期,第87-89页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:评估大剂量糖皮质激素对SARS患者骨代谢的影响。

方法:33例SARS患者,应用糖皮质激素的时间为19~36d,平均24.4d;甲基强的松龙用量为30.8~233.8mg/d,平均145.9mg/d。记录患者应用糖皮质激素开始及第1、2、3、4周时的血清钙、磷、碱性磷酸酶的检测值。应用配对t检验统计方法,分析各指标的动态变化。

结果:随着激素的应用,患者血钙浓度降低,血碱性磷酸酶水平升高,第1、2、3、4周时的血清钙、碱性磷酸酶和初始水平相比,均有显著性差异(P<:0.01或P<:0.05),血磷浓度则无明显变化(P>:0.05)。

结论:SARS患者长时间、超生理剂量应用糖皮质激素,将产生骨代谢失衡,钙吸收减少,骨转换加速,导致骨量丢失。
[关键词]:SARS  糖皮质激素类  骨代谢
 
Effects of large amounts of glucocorticoid on bone metabolism in SARS patients
Abstract:

Objective:To evaluate effects of large dose of glucocorticoid on bone metabolism in SARS patients.

Methods:The lasting time of using glucocorticoid raged from 19 to 36 days,with a mean value of 24.4 days in 33 SARS patients,and they used methylprednisolone with dosage of 30.8~233.8 mg/d,145.9 mg/d in average.Recorded the value of serum calcium,phosphorus,and alkaline phosphatase of these patients at the beginning and on 1st,2nd,3rd and 4th week as using glucocorticoid.The clinical data were analyzed with paired-sample t-test methods.

Results:The serum calcium concentration decreased and the alkaline phosphatase activity increased through the duration of using glucocorticoid.There are very siginificant differences between the values of the two biochemical item on 1st,2nd,3rd and 4th week and that at the beginning (P<0.01 or P<0.05).Serum phosphorus concentration didnt show statistial differences (P>0.05).

Conclusion:It will result in bone metabolism disturbance in SARS patients after using large dose of glucocorticoid for a long time.Calcium intake will reduce and bone turnover will speed up,that will induce bone loss.Its necessary to give prophylactic treatment to prevent the occurrence of osteoprosis in the course of treating SARS with glucocorticoid.
KEYWORDS:Severe acute respiratory syndrome (SARS)  Glucocorticoid  Bone metabolism
 
引用本文,请按以下格式著录参考文献:
中文格式:崔全起,谢利民.大剂量糖皮质激素对SARS患者骨代谢的影响[J].中国骨伤,2004,17(2):87~89
英文格式:CUI Quan-qi,XIE Li-min.Effects of large amounts of glucocorticoid on bone metabolism in SARS patients[J].zhongguo gu shang / China J Orthop Trauma ,2004,17(2):87~89
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