儿童糖皮质激素性骨质疏松的发病机制及诊治

Pathogenesis and treatment progress of glucocorticoid-induced osteoporosis in children

目前，儿童骨质疏松症已成为影响儿童骨骼健康的重要疾病，包括原发性骨质疏松症及继发性骨质疏松症，其中糖皮质激素性骨质疏松症是儿童最常见的继发性骨质疏松症。糖皮质激素被临床广泛用于治疗各种炎性疾病和自身免疫功能紊乱性疾病，如肾病综合征、系统性红斑狼疮等。虽然糖皮质激素具有强大的抗炎、抗过敏及免疫抑制作用，但长期应用会引起多种并发症，如骨质疏松。该综述主要讨论糖皮质激素性骨质疏松症的发病机制及诊治策略，以期为临床儿科医生提供更为广泛的理论依据，并做出合理的评估和临床指导。

Currently osteoporosis in children has become an important disease, which includes primary osteoporosis and secondary osteoporosis. Glucocorticoid induced osteoporosis is the most common secondary os- teoporosis. Glucocorticoid has been widely used in clinical treatment of various inflammatory diseases and auto- immune function disorders, such as nephrotic syndrome and systemic lupus erythematosus. Although glucocorti- cold has strong anti-inflammatory, anti-allergic and immunosuppressive effect,long-term use can cause a variety of complications, such as osteoporosis. This review focuses on the pathogenesis of glucocorticoid induced osteo-porosis and its diagnosis and treatment strategy,in order to provide more extensive theoretical basis for pediatricians, to draw more attention for them, and also to provide appropriate evaluation and clinical guide.