哮喘患儿吸入糖皮质激素对骨代谢影响

Effects of inhaled glucocorticoids on bone metabolism of children with asthma

目的 探讨哮喘患儿吸入糖皮质激素 (IGs)对骨代谢影响。方法 对 5 0例 5～ 12岁连续吸入IGs 2年哮喘患儿 ,于吸入前 ,0 .5、1、1.5、2年分次进行血清钙、磷、骨源性碱性磷酸酶 (BALP)、骨钙素 (OC)水平监测 ,并进行身高生长速度测定。其中观察I组 2 7例 ,平均吸入丙酸倍氯米松 2 5 0 μg/d ;观察Ⅱ组 2 3例 ,平均吸入丙酸氟替卡松 15 0 μg/d ;正常对照组 2 2例。 结果 观察Ⅰ、Ⅱ组、对照组间分次检测的血钙、磷、BALP、OC水平均无显著差异 (P均 >0 .0 5 ) ;且各组间q检验无显著差异 (P均 >0 .0 5 )。观察Ⅰ、Ⅱ组身高生长速度分别于对照组比较 ,均无显著差异 (P均 >0 .0 5 )。结论 每日小剂量较长时间IGs对儿童骨生长发育无明显影响。

Objective To explore the effects of inhaled glucocorticoids (IGs) on bone metabolism in children with asthma.Methods Fifty children with asthma aged 5-15 years who IGs continually for 2 years were investigated and the calaium(Ca),phosphorus(P), bone specific alkaline phosphatase(BALP), osteocalcin(OC) levels of serum were inspected respectively before IGs,0.5,1,1.5,2 years after IGs and growth velocity (GV) in stature was also measured. Among them , belcomethasone inhaled by the 27 cases averaged 250 g per day in group I, fluticasone inhaled by the 23 cases averaged 150 g per day in group II. Twenty-two normal children were included in control group.Results The changes of Ca, P, BALP and OC levels of serum had no significant difference among group Ⅰ,Ⅱ and control group each time (P>0.05). And there were no obvious difference of the q test in each group (P>0.05). There were no obvious difference of GV in stature between group Ⅰ,Ⅱ and control group(P>0.05).Conclusion There are no significant effects on bone metabolism and growth of children with small dose of IGs per day for a longer time.