Bowyer S L, LaMothe M P, Hollister J R
J Allergy Clin Immunol. 1985 Aug;76(2 Pt 1):234-42. doi: 10.1016/0091-6749(85)90708-0.
Sixty steroid-treated patients with asthma were evaluated for the presence of muscle weakness by use of both manual muscle testing and the Cybex II isokinetic dynamometer. The patients were compared to age and sex-matched sedentary control subjects. Forty-eight percent of the patients (12/25) taking greater than or equal to 40 mg per day of prednisone had hip flexor strength greater than or equal to 2 SD below the mean of age and sex-matched control subjects by Cybex testing (CT). Sixty-four percent of the patients (16/25) taking greater than or equal to 40 mg per day of prednisone were found on manual muscle testing to have hip flexor weakness. Only one patient taking less than 30 mg per day of prednisone was found to have muscle weakness. Biochemical parameters, including CPK, aldolase, SGOT, LDH, and LDH isoenzymes were measured to assess the degree of steroid-induced muscle damage. They neither correlated with the degree of hip flexor weakness as measured by CT, nor did they discriminate between patients receiving small doses and large doses of steroids. Changes in urinary excretion of creatine did not help to confirm the diagnosis of steroid myopathy. Although CT provides an objective means of assessing muscle strength in these patients, at this time no definitive chemical test is available for the diagnosis of steroid myopathy.
通过使用徒手肌力测试和Cybex II等速测力计，对60名接受类固醇治疗的哮喘患者进行了肌肉无力情况的评估。将这些患者与年龄和性别匹配的久坐不动的对照受试者进行比较。在接受Cybex测试（CT）时，每天服用泼尼松大于或等于40毫克的患者中有48%（12/25）的髋屈肌力量比年龄和性别匹配的对照受试者的平均值低2个标准差以上。在徒手肌力测试中，每天服用泼尼松大于或等于40毫克的患者中有64%（16/25）被发现存在髋屈肌无力。每天服用泼尼松少于30毫克的患者中只有1例被发现存在肌肉无力。测量了包括肌酸磷酸激酶（CPK）、醛缩酶、谷草转氨酶（SGOT）、乳酸脱氢酶（LDH）和LDH同工酶在内的生化参数，以评估类固醇诱导的肌肉损伤程度。它们既与CT测量的髋屈肌无力程度无关，也无法区分接受小剂量和大剂量类固醇治疗的患者。尿肌酸排泄量的变化无助于确诊类固醇肌病。虽然CT为评估这些患者的肌肉力量提供了一种客观方法，但目前尚无明确的化学检测方法可用于诊断类固醇肌病。
