长期用丙酸倍氯米松治疗常年性变应性鼻炎对患者骨密度影响的临床研究

Effects of long term use of beclomethasone dipropionate nasal spray on bone density with perennial allergic rhinitis

目的：研究长期用丙酸倍氯米松（商品名：伯克纳,BDP）鼻喷雾剂治疗成人常年性变应性鼻炎（AR）对患者骨密度的影响。方法：对36例20～45岁常年性AR患者给予BDP鼻喷雾剂治疗,200μg/d≤剂量≤400μg/d,分级阶梯治疗,定期复查。根据治疗及随诊时间将36例患者分为3组,A组,治疗及随诊时间1～〈3年;B组,治疗及随诊时间3～〈5年;C组,治疗及随诊时间≥5年。分别于治疗前、后测患者的骨密度和血清钙、磷、碱性磷酸酶值,并进行配对资料t检验。结果：经随访观察鼻用BDP鼻喷雾剂治疗的3组成人常年性AR患者的骨密度和血清钙、磷、碱性磷酸酶均值与治疗前比较均差异无统计学意义（均P〉0.05）,显示鼻用BDP鼻喷雾剂剂量≤400μg/d治疗常年性AR,5年内是安全的。结论：长期鼻用BDP鼻喷雾剂200μg/d≤剂量≤400μg/d,对AR患者的骨密度及骨代谢无明显影响。

Objective：To study the effects of long term use of beclomethasone dipropionate （BDP） nasal spray on bone density with perennial allergic rhinitis （AR） in adults. Method：A 5-year randomized study was conducted on the effects of BDP nasal spray on serum calcium, phosphorus, alkaline phosphatase, and bone density determined before and after the treatment in 36 adult patients with perennial AR. 20-45 years of age, were randomly divided into 3 groups. That is group A （nasal spray 1-〈3 year）, group B （nasal spray BDP 3-〈5 year） and group C （nasal spray BDP≥5 year）. The data were analyzed by paired t test. Result：The perennial AR were followed up for more than ≥1 year, ≥3 year and ≥5 year to observe the influences of nasal spray BDP. There were no significant difference between the data examined before and after the treatment （P〉0.05）. Bone development is not influenced by nasal spray BDP≤4400 μg/d within 5 years. Conclusion：Long term use of BDP nasal spray in adult patients does not lead to osteoporosis if the lowest effective steroid dose is given.