Yamamoto Takuaki, Miyanishi Keita, Motomura Goro, Nishida Kenjiro, Iwamoto Yukihide, Sueishi Katsuo
Kyushu University, Department of Orthopaedic Surgery.
Clin Calcium. 2007 Jun;17(6):879-86.
We describe that high-dose methylprednisolone (20 mg/kg) can induce multifocal osteonecrosis (ON) in conjunction with thrombocytopenia, hypofibrinogenemia, and hyperlipemia. Detailed clinical and laboratory evaluations of coagulation system are recommended in those patients who develop manifestations of an abnormal lipid metabolism shortly after high-dose corticosteroid therapy. Moreover, we investigated the effects of the combination treatment with an anticoagulant (warfarin) plus a lipid-lowering agent (probucol) on prevention of steroid-induced osteonecrosis (ON) in this animal model. The incidence of ON in warfarin plus probucol (5%) was significantly lower than that observed in the control group (70%) (p <0.0001). Our results experimentally showed that the combined use of an anticoagulant and a lipid-lowering agent helps prevent steroid-induced ON in rabbits.
我们描述了高剂量甲基泼尼松龙(20mg/kg)可诱发多灶性骨坏死(ON),同时伴有血小板减少、纤维蛋白原血症和高脂血症。对于在高剂量糖皮质激素治疗后不久出现脂质代谢异常表现的患者,建议进行详细的临床和凝血系统实验室评估。此外,我们在该动物模型中研究了抗凝剂(华法林)加降脂剂(普罗布考)联合治疗对预防类固醇诱导的骨坏死(ON)的效果。华法林加普罗布考组的骨坏死发生率(5%)显著低于对照组(70%)(p<0.0001)。我们的结果通过实验表明,抗凝剂和降脂剂联合使用有助于预防兔类固醇诱导的骨坏死。