[吸入性皮质激素对哮喘儿童骨密度的影响]

[The effects of inhaled corticoids on bone density in asthmatic children].

作者信息

Goţia Stela, Rusu Tania, Badiu Irina, Murgu Alina, Rugină Aurica, Ioniuc Ileana

机构信息

Universitatea de Medicină şi Farmacie Gr T Popa Iaşi, Facultatea de Medicină, Clinica a II-a Pediatric.

出版信息

Rev Med Chir Soc Med Nat Iasi. 2005 Jan-Mar;109(1):29-35.

PMID:16607823

Abstract

OBJECTIVE

To evaluate bone status of asthmatic children on chronic inhaled corticoid therapy.

METHODS

Bone densitometry was performed by Quantitative ultrasound (QUS) of the distal radius in 74 asthmatic children, evaluating Z-score; serum levels of 25 hydroxyvitamin D were measured in 10 cases.

RESULTS

28 of 74 children had osteopenia, defined as Z scores lower than -1. Statistic analyzes showed a significant correlation (p <0.05) of osteopenia with the duration of inhaled corticoid therapy (CSI), the absence of correlation with the dose of CSI, age, sex, severity step and duration of the disease. 25 hydroxyvitamin D was low in 8 of the 10 cases with osteopenia. Osteopenia was present in 7 children who were not under CSI, but have received multiple trials of oral corticoids for severe exacerbations.

CONCLUSIONS

Osteopenia was present in 52% of children that were under inhaled corticoids for more than 12 months and it correlated with the duration of CSI, but not with the daily dose. Systemic corticoid use is a significant cause of osteopenia in asthmatic children.

摘要

目的

评估接受慢性吸入性皮质激素治疗的哮喘儿童的骨骼状况。

方法

对74名哮喘儿童进行桡骨远端定量超声（QUS）骨密度测量，评估Z值；对10例患儿测定血清25羟维生素D水平。

结果

74名儿童中有28名存在骨质减少，定义为Z值低于-1。统计分析显示，骨质减少与吸入性皮质激素治疗时长（CSI）显著相关（p<0.05），与CSI剂量、年龄、性别、疾病严重程度分级及病程无关。10例骨质减少患儿中有8例25羟维生素D水平较低。7名未接受CSI但因严重发作多次接受口服皮质激素治疗的儿童存在骨质减少。