在患有喘的患者中,吸入皮质类固醇的使用和骨矿物质密度
C A Wong1, L J Walsh, C J Smith
1Division of Respiratory Medicine, City Hospital, Nottingham, UK. czwong@middlemore.co.nz
Lancet (London, England)
|May 3, 2000
概括
长期使用吸入性皮质类固醇与喘患者的骨矿物质密度降低有关. 较高的累积剂量与较低的骨密度相关,特别是在腰椎和股骨.
科学领域:
- 肺部医学 肺部医学
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 吸入性皮质类固醇 (ICS) 广泛用于喘管理.
- ICS的全身吸收引发了对骨健康的潜在不良影响的担忧.
- 累计ICS剂量对骨矿物质密度 (BMD) 的影响需要澄清,因为广泛和长期使用.
研究的目的:
- 为了研究累积吸入性皮质类固醇暴露和骨矿物质密度之间的剂量反应关系.
- 评估ICS剂量与关键骨部位的BMD之间的关联,在患有喘的成年人.
主要方法:
- 一项研究涉及196名20-40岁的成年人 (119名女性) 患有喘.
- 根据患者病史和病历记录评估累计的ICS剂量.
- 用回归分析测量腰椎和靠近大腿骨的骨矿物质密度.
主要成果:
- 在累积的ICS剂量和腰椎,大腿部,沃德三角和三骨的BMD之间观察到显著的负相关性.
- 累计ICS剂量的翻倍相当于腰椎BMD的0.16 SD降低.
- 这些关联在调整年龄,性别和其他潜在的混因素后仍然显著.
结论:
- 该研究提供了证据表明,喘患者的累积吸入皮质类固醇剂量和骨矿物质密度之间存在负面关系.
- 研究结果表明,长期使用ICS可能会对骨健康产生不利影响,需要监测.
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