泼尼松对肾病综合征患儿骨吸收功能的影响

目的探讨泼尼松对肾病综合征(NS)患儿骨吸收功能的影响。方法以2001年8月至2002年10月河北医科大学第二医院儿科收治的25例NS患儿为研究对象,采用自身对照形式,测定患儿应用泼尼松治疗前(激素治疗前组)和应用足量泼尼松治疗后(激素足量治疗组)尿脱氧吡啶啉排泄率(DPD/Cr)及24h尿钙浓度。结果在激素治疗4~8周后,激素足量治疗组尿DPD/Cr明显高于激素治疗前组(P<0.05),24h尿钙明显升高(P<0.01),但二者无相关性。结论泼尼松足量治疗阶段,NS患儿骨吸收功能增强,易导致骨质疏松;激素治疗期间24h尿钙作为评价骨吸收的指标缺乏特异性。

Effect of prednisone on bone resorption activity of childhood nephrotic syndrome

Objective To investigate the effect of prednisone on bone resorption activity of childhood nephrotic syndrome (CNS).Methods Twenty -five cases,who were from Department of Pediatrics of Second Hospital of Hebei Medical University from August 2001 to October 2002,were enrolled in this self-contrast study.We measured levels of urinary deoxypyridinoline/creatinine(DPD/Cr) and 24h urinary calcium of the patients before prednisone treatment (prednisone-pretreatment group) and the patients after adequate dosage prednisone treatment (adequate dosage prednisone-treatment group).Results The DPD/Cr was obviously increased in adequate dosage prednisone-treatment group compared with prednisone-pretreatment group (P<0.05).The changes of 24h urinary calcium was significant.It was obviously increased in adequate dosage prednisone group compared with prednisone-pretreatment group (P<0.01),but there were no correlation between 24h urinary calcium and DPD/Cr.Conclusion Bone resorption activity is increased in CNS after adequate dosage prednisone treatment.The treatment of adequate dosage prednisone may play an important role in osteoporosis of patients with CNS; 24h urinary calcium lacked specificity as a guideline of evaluating bone resorption activity during the stage of prednisone treatment.