Antelava O A, Smirnov A V, Demin N V, Khitrov A N, Benevolenskaia L I, Nasonov E L
Klin Med (Mosk). 2003;81(2):57-61.
The study was undertaken to examine the impact of glucocorticoid therapy (GCT) on mineral bone density (MBD) in patients with idiopathic inflammatory myopathies. Double-energy X-ray absorptiometry was used to determine MBD of the vertebral column and proximal femur in 42 females (30 with the preserved menstrual cycle (PMC), 12 in postmenopause (PMP) with polymyositis/dermatomyositis (PM/DM). All the patients received GCT. A random population sample including 106 females aged 20 to 69 years formed a control group. MBD of the neck of the femur was significantly lower in patients from all age groups, in the lumbar vertebral column in young (20-29 years) and old (over 50 years) females than in the controls. The development of osteoporosis (OP) was more frequently observed in PMP females: OP in the lumbar spine was in 16.7 and 66.7% of the PMC and PMP females, respectively; that in the neck of the femur was in 11 and 33%. There was no relationship between MBD and the specific features of GCT, namely the duration, cumulative dose, and the maximum dose. There was a reduction in MBD in patients with PM/DM on GCT in all age groups, more frequently in PMP patients.
本研究旨在探讨糖皮质激素治疗(GCT)对特发性炎性肌病患者骨矿物质密度(MBD)的影响。采用双能X线吸收法测定42例女性患者(30例月经周期正常(PMC),12例绝经后(PMP)伴多发性肌炎/皮肌炎(PM/DM))的脊柱和股骨近端的MBD。所有患者均接受GCT治疗。选取106例年龄在20至69岁的女性作为随机人群样本组成对照组。所有年龄组患者的股骨颈MBD均显著低于对照组,年轻(20 - 29岁)和老年(50岁以上)女性的腰椎MBD也低于对照组。绝经后女性更易发生骨质疏松(OP):腰椎OP在月经周期正常女性和绝经后女性中的发生率分别为16.7%和66.7%;股骨颈OP在这两组中的发生率分别为11%和33%。MBD与GCT的具体特征(即治疗持续时间、累积剂量和最大剂量)之间无相关性。所有年龄组接受GCT治疗的PM/DM患者的MBD均有所降低,绝经后患者更为常见。