Hasegawa Minoru, Nisikawa Masakatsu, Nomura Syosaku, Takubo Takayuki, Suehiro Akira, Saigo Katsuyasu, Hayashi Kunio, Tamaki Shigehisa, Mizutani Minoru, Uemura Yasuhiro, Kurata Yosiyuki
Second Department of Internal Medicine, Osaka Medical College.
Rinsho Ketsueki. 2005 Feb;46(2):121-6.
To elucidate the effects of glucocorticoid on bone mineral density in idiopathic thrombocytopenic purpura (ITP) patients, we retrospectively evaluated the relationship between bone mineral density (BMD) and the total dose of glucocorticoid or the mean daily dose given. We found decreased BMD in 66.7% of the patients with ITP to whom glucocorticoid was given, though rather normal bone BMD was observed in 28.6% of ITP patients treated without steroids. The mean level of BMD was markedly decreased in steroid-treated patients compared with steroid non-treated patients (p < 0.01). The relationship between BMD and the total dose of glucocorticoid (p = 0.023) or the mean daily dose revealed a negative correlation (p = 0.022). This study showed that glucocorticoid-induced osteoporosis was observed in patients with ITP, similar to other diseases already reported. When we think of this disease, many cases tend to be followed for a long time, and as the majority of ITP patients is female, we should pay particular attention in the prevention of glucocorticoid-induced osteoporosis.
为阐明糖皮质激素对特发性血小板减少性紫癜（ITP）患者骨密度的影响，我们回顾性评估了骨密度（BMD）与糖皮质激素总剂量或每日平均剂量之间的关系。我们发现，接受糖皮质激素治疗的ITP患者中，66.7%的患者骨密度降低，而在未接受类固醇治疗的ITP患者中，28.6%的患者骨密度相当正常。与未接受类固醇治疗的患者相比，接受类固醇治疗的患者的平均骨密度水平显著降低（p < 0.01）。骨密度与糖皮质激素总剂量（p = 0.023）或每日平均剂量之间的关系呈负相关（p = 0.022）。本研究表明，ITP患者中观察到糖皮质激素诱导的骨质疏松，这与已报道的其他疾病类似。当我们考虑这种疾病时，许多病例往往需要长期随访，而且由于大多数ITP患者为女性，我们应特别注意预防糖皮质激素诱导的骨质疏松。
