Kimberly R P
Hospital for Special Surgery, Cornell University Medical College, New York, New York.
Curr Opin Rheumatol. 1994 May;6(3):273-80. doi: 10.1097/00002281-199405000-00005.
Despite the continuing debate about the risks and benefits of glucocorticoid, their central role in the therapeutic armamentarium remains undisputed. Studies continue to unravel the complexity of their biologic effects on gene transcription, and careful clinical observation refines their therapeutic use. Although cloaked in controversy, some recent highlights include the possibility that high-dose intravenous methylprednisolone may affect the development of multiple sclerosis, the suggestion that prednisone may have little efficacy in the management of high-risk pregnancy in patients with antiphospholipid antibodies, and several observations that administration of calcium and vitamin D prevents bone loss in patients receiving steroids.
尽管关于糖皮质激素的风险和益处仍存在持续的争论，但它们在治疗药物中的核心作用仍然无可争议。研究不断揭示其对基因转录的生物学效应的复杂性，而细致的临床观察也在优化它们的治疗用途。尽管存在争议，但近期的一些亮点包括：大剂量静脉注射甲泼尼龙可能影响多发性硬化症的发展；有观点认为泼尼松在抗磷脂抗体患者的高危妊娠管理中可能疗效甚微；还有多项观察表明，补充钙和维生素D可预防接受类固醇治疗患者的骨质流失。
