CAJ | 학술논문

目的：探讨短期应用小剂量糖皮质激素（GCs）对男性强直性脊柱炎（AS）患者骨代谢及骨密度的影响。方法：46例男性AS患者分为常规治疗组（22例，予免疫抑制剂+非甾体抗炎药）和GCs组（24例，在常规治疗基础上加用小剂量激素），检测2组治疗6个月前后血清骨保护素（OPG）、巨噬细胞-集落刺激因子（M-CSF）、血沉（ESR）、血清C反应蛋白（CRP）及BASDAI评分、骨密度（BMD）变化。结果：与治疗前比较，2组治疗后OPG水平显著升高（P＜0.05）；ESR、CRP、BASDAI评分显著降低（P＜0.05）；M-CSF水平亦降低，其中GCs组变化差异有统计学意义（P＜0.05）。治疗后2组间比较，OPG和M-CSF水平及BMD差异无统计学意义（P＞0.05）；ESR、CRP、BASDAI评分差异有统计学意义（P＜0.05）。结论：短期联合应用小剂量激素影响AS患者骨代谢指标及炎性指标，对BMD影响不大，其在AS治疗中是安全有益的。
목적：탐토단기응용소제량당피질격소（GCs）대남성강직성척주염（AS）환자골대사급골밀도적영향。방법：46례남성AS환자분위상규치료조（22례，여면역억제제+비치체항염약）화GCs조（24례，재상규치료기출상가용소제량격소），검측2조치료6개월전후혈청골보호소（OPG）、거서세포-집락자격인자（M-CSF）、혈침（ESR）、혈청C반응단백（CRP）급BASDAI평분、골밀도（BMD）변화。결과：여치료전비교，2조치료후OPG수평현저승고（P＜0.05）；ESR、CRP、BASDAI평분현저강저（P＜0.05）；M-CSF수평역강저，기중GCs조변화차이유통계학의의（P＜0.05）。치료후2조간비교，OPG화M-CSF수평급BMD차이무통계학의의（P＞0.05）；ESR、CRP、BASDAI평분차이유통계학의의（P＜0.05）。결론：단기연합응용소제량격소영향AS환자골대사지표급염성지표，대BMD영향불대，기재AS치료중시안전유익적。
Objective: Explore the change of bone mineral density and bone metabolism in male patients with ankylosing spondylitis by short-term and low-dose glucocorticoid.Methods: Randomly divide 46 patients into non-GC treatment group (22) and low-dose GC treatment group (24). Non-GC treatment group receive DMARD and Ca, Low-dose GC treatment group receive low dose glucocorticoid as well as DMARD and Ca. The Serum levels of osteoprotegerin (OPG), macrophage-colony stimulating factors (M-CSF), erythrocyte sedi-mentation rate (ESR), c-reactive protein (CRP), bath AS disease activity index (BASDAI) and Bone mineral density (BMD) were measured at the baseline and 6 months after therapy.Results: Six months after treatment, the level of OPG increased signiifcantly (P<0.05) and the level of ESR, CRP, BASDAI decreased signiifcantly (P<0.05) in both groups respectively, compared with that at the baseline; the level of M-CSF of two treatment groups decreased, in which the low-dose GC treatment group did more signiifcantly (P<0.05). Six months after treatment, there was no signiifcant difference in the levels of OPG, M-CSF, and BMD (P<0.05) between the two groups. There was signiifcant difference in the levels of ESR, CRP, BASDAI between the two groups (P>0.05). Conclusion: Short-term treatment of low-dose GC affect bone metabolisms and inlfamed index, while with no signiifcant inlfuence on BMD in AS patients. It is safe and beneift for AS patients.