糖皮质激素对风湿免疫病患者骨密度的影响探讨

Effect of Glucocorticoid on Bone Mineral Density in Patients with Rheumatic Immune Disease

目的:研究糖皮质激素对风湿免疫病患者骨密度的影响。方法:选取笔者所在医院2017年12月-2019年12月收治的120例风湿免疫疾病患者的资料进行回顾性分析,并根据是否使用糖皮质激素分为治疗组和对照组,对照组采用免疫抑制剂治疗,治疗组在此基础上使用糖皮质激素治疗,对比两组患者治疗前后骨密度情况,分析糖皮质激素使用量与骨密度的相关性。结果:治疗前两组前臂、腰椎、髋部骨密度比较差异无统计学意义(P>0.05),治疗6个月后,治疗组前臂、腰椎、髋部骨密度均低于对照组,差异均有统计学意义(P<0.05)。治疗组中RA、SLE、SS患者糖皮质激素使用量比较差异有统计学意义(P<0.05);治疗组中RA、SLE治疗后前臂、髋部、腰椎骨密度均低于治疗前,差异均有统计学意义(P<0.01),SS患者治疗前后各部位骨密度比较差异无统计学意义(P>0.05);RA,SLE患者糖皮质激素使用量与前臂、髋部、腰椎骨密度呈负相关(P<0.05),SS患者糖皮质激素使用量与前臂、髋部、腰椎骨密度无相关性(P>0.05)。结论:糖皮质激素对部分风湿免疫病患者骨密度有一定影响。

Objective:To study the effect of Glucocorticoid on bone mineral density in patients with rheumatic immune disease.Method:The data of 120 patients with rheumatic immune diseases admitted to the hospital of the author from December 2017 to December 2019 were selected for regression analysis,they were divided into treatment group and control group according to whether glucocorticoid was used,the control group was treated with immunosuppressant therapy,and the treatment group was treated with glucocorticoid therapy on this basis.The BMD of the two groups before and after treatment was compared,and the correlation between the dosage of glucocorticoid and BMD was analyzed.Result:Before treatment,there was no significant difference in BMD of forearm,lumbar spine and hip between the two groups(P>0.05),6 months after treatment,BMD of forearm,lumbar spine and hip in the treatment group was lower than that in the control group,the difference was statistically significant(P<0.05).There were statistically significant differences in the amount of glucocorticoids in RA,SLE and SS patients in the treatment group(P<0.05).In the treatment group,the bone density of forearm,lumbar spine and hip in RA and SLE patients was lower than that before treatment,the difference was statistically significant(P<0.01),while there was no statistically significant difference in the bone density of different parts of SS patients before and after treatment(P>0.05).In RA and SLE patients,the amount of glucocorticoids was negatively correlated with the bone density of forearm,hip and lumbar vertebrae(P<0.05),in SS patients,the amount of glucocorticoids was not correlated with the bone density of forearm,hip and lumbar vertebrae(P>0.05).Conclusion:Glucocorticoid has certain effect on BMD of some rheumatic immune disease patients.