免疫调节剂治疗对多发性硬化症患者骨密度的有益影响。
Favorable effect of immunomodulator therapy on bone mineral density in multiple sclerosis.
机构信息
Department of Neurology, St. James's Hospital, Dublin, Ireland.
出版信息
Ir J Med Sci. 2009 Mar;178(1):43-5. doi: 10.1007/s11845-008-0253-9. Epub 2008 Nov 12.
BACKGROUND
Osteoporosis is a complication of multiple sclerosis (MS), especially if corticosteroid therapy is given. Little is known about the effect on bone of immunomodulatory therapy (IMT) for MS.
AIM
We sought to evaluate bone mass in patients with MS on IMT.
METHODS
We measured bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA) in 37 patients with MS who received IMT. Different IMTs were administered: interferon beta-1a in 70%, interferon beta-1b in 27% and Glatiramer in 3%. High-dose pulse corticosteroid therapy (intravenous methylprednisolone 500 mg) was given to 81% ranging from 1 to 17 courses.
RESULTS
Both mean BMD Z-score at spine of 0.53 (CI, 0.15-0.92; P = 0.0084) and mean BMD Z-score at femur of 0.72 (CI, 0.42-1.01; P < 0.0001) were significantly greater than zero.
CONCLUSIONS
IMT may have a favorable effect on bone in patients with MS even in the presence of pulse steroid therapy.
背景
骨质疏松症是多发性硬化症（MS）的一种并发症，尤其是在给予皮质类固醇治疗的情况下。对于 MS 的免疫调节治疗（IMT）对骨骼的影响知之甚少。
目的
我们旨在评估接受 IMT 的 MS 患者的骨量。
方法
我们通过双能 X 射线吸收法（DXA）测量了 37 名接受 IMT 的 MS 患者的骨矿物质密度（BMD）。给予不同的 IMT：70%接受干扰素 beta-1a，27%接受干扰素 beta-1b，3%接受 Glatiramer。81%的患者接受了高剂量脉冲皮质类固醇治疗（静脉内甲基强的松龙 500mg），疗程为 1 至 17 个疗程不等。
结果
脊柱的平均 BMD Z 评分（CI，0.15-0.92；P=0.0084）和股骨的平均 BMD Z 评分（CI，0.42-1.01；P<0.0001）均显著大于零。
结论
即使存在脉冲类固醇治疗，IMT 也可能对 MS 患者的骨骼产生有利影响。
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