1,2-二氯乙烷中毒糖皮质激素治疗与骨量变化的关系

The relationship between glucocorticoid treatment and bone mass change in patients with 1, 2-dichloroethane poisoning

目的评估糖皮质激素对职业性急性1,2-二氯乙烷中毒患者骨量的影响。方法选取广州医学院附属第十二人民医院2009年～2012年期间应用糖皮质激素治疗的职业性急性1,2-二氯乙烷中毒患者38例,采用双能X线骨密度仪测定相关部位的骨密度,记录体重指数(BMI)、激素应用累计时间、累计剂量、单日最大量及每日平均量等临床资料,资料录入和统计采用SPSS统计软件包。结果激素应用累计时间、剂量和单日最大量以及BMI对骨量存在影响(P<0.05),而激素应用每日平均量则与骨量无相关性(P>0.05)。结论职业性急性1,2-二氯乙烷中毒患者应用糖皮质激素可引起骨量减少或骨质疏松。应严格控制激素应用的累计时间、剂量和单日最大量,预防并发症的发生。

【Objective】To evaluate the impact of glucocorticoid on bone mass in patients with occupational acute 1,2-dichloroethane poisoning.【Methods】 Between 2009 and 2012,38 patients with occupational acute 1,2 dichloroethane poisoning underwent glucocorticoid treatment at our hospital.Dual-energy X-ray absorptiometry was used to measure bone mineral density.Body mass index（BMI）,the cumulative duration,cumulative dose,maximum daily dose,and average daily dose of hormone therapy,and other clinical parameters were recorded.SPSS 16.0 software was used for statistical analysis.【Results】The cumulative duration,cumulative dose and the maximum daily dose of hormone therapy as well as BMI were associated with osteoponia（P〈 0.05）,whereas the average daily dose of hormone therapy showed no relationship with osteoponia（P〈 0.05）.【Conclusions】Glucocorticoid can cause osteoponia in patients with occupational acute 1,2-dichloroethane poisoning.The cumulative duration,cumulative dose and the maximum daily dose of hormone therapy should be strictly controlled to prevent the occurrence of such complications.