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糖皮质激素对血清脂质谱、内皮功能及动脉壁力学的影响。

Effect of glucocorticoids on serum lipid profile and endothelial function and arterial wall mechanics.

作者信息

Yadav Anita, Jahan Afsana, Yadav Tribhuvan Pal, Sachdev Namrita, Chitkara Anubhuti, Asare Ram

机构信息

Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

出版信息

Indian J Pediatr. 2013 Dec;80(12):1007-14. doi: 10.1007/s12098-013-1035-6. Epub 2013 May 22.

Abstract

OBJECTIVE

To determine the effect of glucocorticoids on lipid profile, endothelial function and arterial wall mechanics in children.

METHODS

Thirty patients who had received glucocorticoids for 4 to 8 wk were compared with 30 age and sex matched healthy controls. Baseline evaluation included weight, height, body mass index (BMI), blood pressure (BP), lipid profile and Ultrasonographic evaluation of brachial artery for endothelial dependant as well as endothelial independent vasodilatation and evaluation of common carotid artery for intima media thickness (IMT) and arterial wall mechanics. All of these parameters were evaluated two more times- after 4 wk of steroid therapy and 2 wk after stopping the drug.

RESULTS

Patients were found to have significant increase in BMI; systolic and diastolic BP; total and LDL cholesterol and carotid IMT and also a decrease in cross sectional compliance (CSC) after 4 wk of steroid therapy (oral prednisolone). However, all these parameters returned towards baseline, 2 wk after stopping the drug. No endothelial dysfunction was observed in these patients.

CONCLUSIONS

Four to eight wk of glucocorticoids use in children leads to reversible changes in BMI, systolic and diastolic BP, total and LDL cholesterol, carotid IMT and CSC.

摘要

目的

确定糖皮质激素对儿童血脂谱、内皮功能和动脉壁力学的影响。

方法

将30例接受糖皮质激素治疗4至8周的患者与30例年龄和性别匹配的健康对照者进行比较。基线评估包括体重、身高、体重指数(BMI)、血压(BP)、血脂谱,以及对肱动脉进行超声检查以评估内皮依赖性和非内皮依赖性血管舒张功能,对颈总动脉进行评估以测量内膜中层厚度(IMT)和动脉壁力学。所有这些参数在类固醇治疗4周后以及停药2周后再评估两次。

结果

发现患者在接受类固醇治疗(口服泼尼松龙)4周后,BMI、收缩压和舒张压、总胆固醇和低密度脂蛋白胆固醇以及颈动脉IMT显著增加,横截面顺应性(CSC)降低。然而,停药2周后,所有这些参数均恢复至基线水平。这些患者未观察到内皮功能障碍。

结论

儿童使用糖皮质激素4至8周会导致BMI、收缩压和舒张压、总胆固醇和低密度脂蛋白胆固醇、颈动脉IMT和CSC出现可逆性变化。

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