SARS患者短期大剂量激素治疗对腰椎骨密度的影响

目的采用定量CT(QCT)骨密度仪测量激素治疗康复SARS患者腰椎的骨密度(BMD)，以监测短时间大剂量静脉用激素治疗对腰椎BMD的影响。方法采用GE CT／e型CT扫描机和QCT-5000型QCT骨密度测量体模和软件，测量了128例使用激素治疗的康复SARS患者和116例对照组人群L2-4腰椎椎体BMD。进行统计学处理，检验使用激素治疗SARS患者的腰椎BMD与对照组或文献报道值之间差别的显著性。结果128例使用激素治疗的康复SARS患者，其中82例平均使用激素剂量3773mg，其余46例使用了激素但不知确切剂量。其中男性23例，平均腰椎BMD为148．2mg／cm^3，与对照组(37例)年龄相当，平均腰椎BMD为142．9mg／cm^3，两组之间差异无显著性。女性两组年龄不匹配，选择20—49岁范围，每10岁为一组分别与对照组和文献报道的相对应年龄段进行比较，两组之间差异均无显著性。结论治疗SARS所采用的短时间大剂量静脉用激素在用药后半年时间没有引起腰椎BMD减低。

Effect of short-term,high-dose corticosteroids on spinal bone mineral density in recovered SARS patients

Objective To investigate the effect of short-term, high-dose corticosteroids used intravenously for treating SARS patients on their spinal bone mineral density (BMD). Methods Lumbar vertebral BMD of 128 corticosteroids-treated SARS patients and 116 controls was measured with a GE CT scanner and QCT-5000 calibration phantom and software. Statistical analysis was performed to determine the significance of the differences in BMD between SARS patients, controls and literature-reported values. Results Of 128 corticosteroids-treated SARS patients, the mean corticosteroid dose of 82 patients was 3773 mg, the dose of the remaining 46 was unknown. The difference in mean BMD of 23 male SARS patients (148.2 mg/cm~3) wiht 37 age-matched male controls (142.9 mg/cm~3) was not statistically significant. The mean age between two female gruops was not matched, therefore the females were grouped by decades of age, the SARS group was then compared with controls, as well as literature-reported values in each age group. The differences between SARS and controls or reported values were not significant for all age groups. Conclusions Short-term high-dose corticosteroids used intravenously for treating SARS patients do not cause decrease in BMD spinal half year after use.