CAJ | 학술논문

目的了解上海和浙江地区风湿病患者糖皮质激素相关骨质疏松(GIOP)现况及高危因素.方法在上海市和浙江省的7家医院内对使用糖皮质激素的风湿病患者进行多中心调查,调查内容包括患者基本情况、疾病史、激素使用史、骨折史及药物治疗史,同时进行常规及生化检查、骨密度、骨代谢标志物检查.了解GIOP患病率、治疗现况.采用x2检验、单因素方差分析等方法分析以上因素与GIOP的关系.结果在605例风湿病患者(主要包括SLE、RA、SS、血管炎等患者)中,GIOP患病率达到39.0％(236例),骨量减少达41.7％(252例),显著高于骨量正常者19.3％(117例).其中SLE(198例)和RA(175例)患者更易出现骨量异常分别占80.3％(159例)和84.6％(148例).GIOP的高危因素包括年龄、疾病病程、身高、体质量、绝经和骨折史等.45.5％(275例)的患者未使用任何药物进行GIOP的干预.结论长期使用激素的患者更易发生骨量减少和GIOP,随着病程延长,GIOP发生率越高.因此,我们必须进一步关注和重视GIOP的防治工作.
목적 료해상해화절강지구풍습병환자당피질격소상관골질소송(GIOP)현황급고위인소.방법 재상해시화절강성적7가의원내대사용당피질격소적풍습병환자진행다중심조사,조사내용포괄환자기본정황、질병사、격소사용사、골절사급약물치료사,동시진행상규급생화검사、골밀도、골대사표지물검사.료해GIOP환병솔、치료현황.채용x2검험、단인소방차분석등방법분석이상인소여GIOP적관계.결과 재605례풍습병환자(주요포괄SLE、RA、SS、혈관염등환자)중,GIOP환병솔체도39.0％(236례),골량감소체41.7％(252례),현저고우골량정상자19.3％(117례).기중SLE(198례)화RA(175례)환자경역출현골량이상분별점80.3％(159례)화84.6％(148례).GIOP적고위인소포괄년령、질병병정、신고、체질량、절경화골절사등.45.5％(275례)적환자미사용임하약물진행GIOP적간예.결론 장기사용격소적환자경역발생골량감소화GIOP,수착병정연장,GIOP발생솔월고.인차,아문필수진일보관주화중시GIOP적방치공작.
Objective To investigate the prevalence of glucocorticoid-induced osteoporosis (GIOP) and the associated risk factors.Methods Patients with rheumatic disease were investigated in several hospitals in Shanghai and Zhejiang.We investigated the demographic data,the usage of glucocorticoids and other medications,the laboratory tests results including blood routine test,biochemical profiles,bone metabolism biomarkers as well as bone mineral density (BMD) were collected.The prevalence of GIOP and the relationship between the category of rhematic diseases,disease course,the dose of glucocorticoids used,other medications and therapy for osteoporosis.Results Six hundred and five patients were investigated,including patients with systemic lupus erythematosus (SLE),rheumatiod arthritis (RA),Sj(o)gren's syndrome (SS),vasculitis and other connective tissue diseases.Among them,39.0％ (236 cases) patients had osteoporosis (OP),41.7％(252 cases) patients had osteopenia,which was significantly higher than general population (19.3％,117 cases).The patients with abnormal BMD accounted for 80.3％ (159 cases) and 84.6％ (148 cases) of them,respectively.The high risk factors of GIOP included age,the course of disease,height,menopause and history of fracture.In our study,45.5％(275 cases) patients did not accept any GIOP prevention medication.Conclusion Patients who have long-term glucocorticoids therapy tend to suffer from OP.The incidence of GIOP increases with the course of the disease.Therefore,we should pay more attention to the prevention of GIOP.