Bijlsma J W, Duursma S A, Huber-Bruning O
Ann Rheum Dis. 1986 Sep;45(9):757-60. doi: 10.1136/ard.45.9.757.
The deleterious effects of corticosteroids (CS) on bone are well known, but probably differ depending on duration and dosage of CS therapy. Presently huge amounts of CS are given over a short period of time in different rheumatic conditions. Not much is known about the effect of this kind of CS treatment on bone metabolism. Twenty patients with persistently active rheumatoid arthritis were treated with 1 g methylprednisolone (MP) three times on alternate days over a five day period. Twenty four hours after the first MP pulse serum calcium was increased and the values of parathyroid hormone and 1,25-dihydroxyvitamin D tended to increase. After the second MP pulse, however, these values had returned to the starting values. The urinary calcium excretion increased during MP pulse therapy and returned to the initial value immediately after the pulse therapy. The hydroxyproline excretion tended to decrease during therapy and stayed decreased immediately afterwards, indicating a decrease in bone resorption. It is concluded that bone metabolism is not seriously affected during MP pulse therapy.
皮质类固醇（CS）对骨骼的有害影响众所周知，但可能因CS治疗的持续时间和剂量而异。目前，在不同的风湿性疾病中，短期内会大量使用CS。关于这种CS治疗对骨代谢的影响，人们了解得并不多。20例持续性活动类风湿关节炎患者在5天内每隔一天接受3次1g甲泼尼龙（MP）治疗。首次MP冲击后24小时，血清钙升高，甲状旁腺激素和1,25-二羟维生素D值趋于升高。然而，第二次MP冲击后，这些值又回到了起始值。MP冲击治疗期间尿钙排泄增加，冲击治疗后立即恢复到初始值。治疗期间羟脯氨酸排泄趋于减少，随后立即保持减少，表明骨吸收减少。结论是，MP冲击治疗期间骨代谢未受到严重影响。
