小剂量糖皮质激素短期治疗男性强直性脊柱炎对骨代谢指标和骨密度的影响及安全性研究

Effects and Safety of Low-dose and Short-term Glucocorticoid on Bone Metabolism and Bone Mineral Density in Male Patients with Ankylosing Spondylitis

目的探讨应用小剂量糖皮质激素短期治疗男性强直性脊柱炎的临床疗效及对患者骨代谢和骨密度的影响。方法 70例男性强直性脊柱炎患者随机分为研究组和对照组各35例,对照组给予非甾体抗炎药、DMARDs和钙剂等基础药物治疗,研究组在对照组基础治疗的基础上给予小剂量糖皮质激素（口服泼尼松,5~10mg·d-1）治疗,观察两组患者骨代谢和骨密度变化情况。结果治疗前后2组患者血清钙、磷、PTH指标及骨密度指标比较差异无统计学意义（P〉0.05）;治疗后CRP、ESR水平及BASDAI评分研究组与对照组比较差异有统计学意义（P〈0.05）;不良反应发生率2组差异无统计学意义（P〉0.05）。结论小剂量糖皮质激素短期治疗男性强直性脊柱炎可有效改善患者临床症状,且对患者骨密度和骨代谢影响较小,未出现严重不良反应,可作为临床治疗备选方案之一。

Objective To explore the effects of low-dose glucocorticoid therapy on bone metabolism and bone mineral density in male patients with ankylosing spondylitis.Methods 70 male patients with ankylosing spondylitis who were treated in our hospital from March 2014 to March 2016 were randomized into study group（35cases）and control group（35cases）.Control group were given non-steroidal anti-inflammatory drugs,DMARDs and calcium.Study group were given small-dose corticosteroids（oral prednisone 5-10 mg once a day）plus the medications given to control group.The changes of bone metabolism and density of two groups were observed.Results Before and after treatment there was no significant difference in serum calcium,phosphorus,PTH indicators and bone mineral density index in the two groups（P〉0.05）.Compared with the control group,CRP levels,ESR levels and BASDAI score in study group had statistical significance（P〈0.05）.The adverse reaction occurrence between two groups was of no statistical significance（P〉0.05）.Conclusion Treating male patients with ankylosing spondylitis by low-dose and short-term glucocorticoid could effectively improve the clinical symptoms of patients,with less effects on bone density and metabolism and no serious adverse reactions.So,it is worth clinical promotion.