皮质类固醇治疗绝经前女性系统性红斑狼疮患者骨密度降低研究

目的　探讨疾病本身和慢性激素治疗对系统性红斑狼疮患者骨密度 (BMD)的影响 ,并确定与已报道的其他种族BMD之间的差异。方法　用双能量X线吸收测量仪分别测定激素治疗绝经前中国狼疮患者和正常对照各 5 2例的腰椎、髋关节及其亚区和整个身体的BMD。结果　狼疮患者以下部位的BMD显著低于正常对照 :腰椎 (P =0 0 0 1)、髋关节Ward’s三角 (P =0 0 3)、整个髋关节 (P =0 0 5 )和整个身体 (P =0 0 4 ) ;各个部位的BMD与病程、病情活动或激素治疗均无相关性 ;根据每日随意补钙将患者分为补钙和未补钙两组 ,未补钙患者BMD均呈显著性低于对照研究和补钙患者 ,正常对照与补钙患者之间无显著性差异。结论　激素治疗的中国女性SLE患者BMD均显著性降低 ,患者骨质疏松发生率低于国外报道表明中国患者的BMD降低低于其他种族的报道。

STUDY ON THE DECREASE OF BONE MINERAL DENSITY IN PRE-MENOPAUSAL WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS TREATED WITH CORTICOSTEROIDS

Objective To investigate the adverse effect of disease and chronic corticosteroid therapy on bone mineral density (BMD) in patients with systemic lupus erythematosus (SLE) in Chinese populations, and determine whether the BMDs were different from that of other ethnic groups reported. Methods Lumbar spine, hip (total and sub regions) and total body BMDs were measured in 52 pre-menopausal Chinese women with SLE treated with prednisone by using dual-energy X-ray absorptiometry, and compared with those from healthy controls matched. Results Compared to controls, SLE patients were found to have lower BMDs at several sites: the lumbar spine (P=0.001), Ward’s triangle (P=0.03), total body (P=0.04) and total hip (P=0.05). There was no correlation between BMDs at any region and duration of disease, activity of disease or prednisone therapy. After SLE patients subgrouped according to those not on calcium and those arbitrarily receiving calcium supplements, significantly lower BMDs were found in those not on calcium compared to both controls and SLE patients on calcium. BMDs in SLE patients on calcium were not different from those in controls. Conclusion BMD in Chinese SLE patients on corticosteroid therapy was significantly lowered, the low prevalence of osteoporosis in SLE patients suggests significant loss of BMD in Chinese SLE patients on corticosteroid therapy is less than that reported in other ethnic groups.