口服糖皮质激素患者骨代谢与下颌骨密度变化及相关性的研究  

Study of the relationship and changes of bone metabolism and mandibular bone mineral density in patients under oral administration of glucocorticoid

作　　者：孙青[1] 张遵[1] 杨柳青[1] 魏辰轩[1] 王晓丽[1] 

机构地区：[1]上海交通大学附属第一人民医院口腔科,上海200080

出　　处：《口腔医学》2012年第7期396-398,402,共4页Stomatology

基　　金：上海市科学技术委员会资助项目(081411967000)

摘　　要：目的初步探讨长期口服糖皮质激素(glucocorticoid,GC)患者血、尿骨代谢指标、全身骨密度(bone mineral density,BMD)、颌骨BMD的变化及其之间的相关性。方法采用自身对照法检测30例患者口服GC前后血碱性磷酸酶(alkalinephosphate enzyme,ALP)、血骨钙素(bone gla protein,BGP)、血钙(calcium,Ca)、尿钙(urine calcium,UCa)及尿肌酐(urine creat-inine,UCr)值的变化;使用双能X线骨密度仪测定全身BMD的变化;应用图像处理软件分析头面部曲面体层片,测定颏孔区下缘皮质骨厚度(cortical width,CW)、下颌骨平均灰度值(mean grey values,MGVs)。用SPSS17.0软件包对检测结果进行统计学分析。结果血Ca与全身BMD、颏孔区下缘CW、下颌骨MGVs显著正相关。全身BMD、颏孔区下缘CW、下颌骨MGVs两两显著正相关。血、尿骨代谢指标、全身BMD、颏孔区下缘CW、下颌骨MGVs在服用GC前后未见明显变化。结论口腔曲面体层片的计算机灰度法可作为检测颌骨BMD的有效方法。本研究中口服GC患者未发生糖皮质激素性骨质疏松(glucocor-ticoid induced osteoporosis,GIO),颌骨骨质疏松得到了预防。Objective To investigate the relationship and changes of the bone metabolism indexes,bone mineral density（BMD） and mandibular BMD in patients under long-time oral administration of glucocorticoid（GC）.Methods Dual-energy X-ray absorptiometry was used to measure BMD,and image processing software was used to detect cortical width（CW） and mean grey values（MGVs） of mandibular bone in panoramic tomograph.Simultaneously,serum alkaline phosphate enzyme（ALP）,serum bone gla protein（BGP）,serum calcium（Ca）,urine calcium（UCa） and urine creatinine（UCr） were examined before and after medication.The medication lasted for 1 year.All statistical analysis were performed with SPSS17.0 software package.Results The relativity between serum Ca and BMD,CW and MGVs of mandibular bone was significantly positive.The relativity between either two of BMD,CW and MGVs of mandibular bone was significantly positive.There were no significant differences in the changes of bone metabolism indexes,BMD,CW and MGVs of mandibular bone before and after medication.Conclusions The results showed that the computerized MGVs method with stomatological panoramic tomograph was simple and effective to measure the density of mandibular bone.The patients who undergone long-time of oral administration of glucocorticoid got prevention of glucocorticoid induced osteoporosis（GIO） and mandibular osteoporosis.

关 键 词：口服糖皮质激素 骨代谢指标 骨密度 曲面体层片 灰度值 

分 类 号：R780.2[医药卫生—口腔医学]