糖皮质激素相关性骨质疏松性骨折。

Department of Internal Medicine, College of Medicine, University of Dammam, King Fahd University Hospital, P O Box 40071, Al-Khobar 31952, Saudi Arabia.

Singapore Med J. 2010 Dec;51(12):948-51.

INTRODUCTION

This study was conducted to evaluate the prevalence of fractures secondary to steroid use.

METHODS

A total of 165 patients (100 male and 65 female) who received glucocorticoid therapy at a dose of 7.5 mg or more, or its equivalent, for more than six months were identified from July 1, 2007 to December 30, 2007. Data extracted included age, gender, dose of glucocorticoid, concomitant diseases, the use of anti-resorptive therapy, calcium and vitamin D supplementation, and the results of bone mineral density (BMD) tests, if performed. Any fragility fractures, the site involved and the treatment administered were also recorded. The data was entered and analysed using the Statistical Package for the Social Sciences.

RESULTS

140 patients had no fractures while 25 (15.2 percent) sustained an osteoporotic fracture. The age (p-value less than 0.5), dose of steroids (p-value less than 0.001) and duration of glucocorticoid therapy (p-value less than 0.001) were significantly higher among patients who sustained fractures. Of these, 12 were male and 13 were female. None of the patients in both groups was started on antiresorptive therapy. The dosage of glucocorticoids was higher among women than men (11.5 versus 24.5 mg/day, p-value is 0.05). The commonest sites of osteoporotic fracture were the spine (44 percent) and proximal femur (24 percent). Eight out of 11 patients had more than one vertebra involved.

CONCLUSION

Fractures due to steroid-induced osteoporosis could have been prevented if appropriate measures were taken.

简介

本研究旨在评估因使用类固醇而导致骨折的发生率。

方法

我们从 2007 年 7 月 1 日至 2007 年 12 月 30 日期间，选取了 165 名（男 100 名，女 65 名）接受剂量为 7.5 毫克或以上，或其等效剂量的糖皮质激素治疗超过 6 个月的患者。提取的数据包括年龄、性别、糖皮质激素剂量、合并症、抗吸收治疗、钙和维生素 D 补充剂的使用，以及骨密度（BMD）检测结果（如果进行了的话）。同时记录任何脆性骨折的情况，包括涉及的部位和所采用的治疗方法。数据使用社会科学统计软件包进行输入和分析。

结果

140 名患者无骨折，25 名（15.2%）发生骨质疏松性骨折。骨折组患者的年龄（p 值小于 0.05）、类固醇剂量（p 值小于 0.001）和糖皮质激素治疗时间（p 值小于 0.001）明显更高。其中，男性 12 例，女性 13 例。两组患者均未开始使用抗吸收药物。女性糖皮质激素剂量高于男性（11.5 毫克/天比 24.5 毫克/天，p 值为 0.05）。骨质疏松性骨折最常见的部位是脊柱（44%）和股骨近端（24%）。11 名患者中有 8 名有一个以上椎体受累。