糖皮质激素对急性ITP患儿骨密度和成骨细胞功能影响及维生素D干预研究  

Effects of glucocorticoid on bone density and osteoblasts in children with acute ITP and the intervention of vitamin D

作　　者：李彦格[1] 李慧霞[1] 刘炜[1] 毛彦娜[1] 张红梅[1] 

机构地区：[1]郑州市儿童医院血液科,450053

出　　处：《中国实用医刊》2012年第20期53-55,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨糖皮质激素对急性特发性血小板减少性紫癜（ITP）患儿骨密度及成骨细胞功能的影响及应用维生素D后的变化。方法将急性ITP患儿分为两组，均用糖皮质激素（每日泼尼松2mg／kg）治疗3周。对照组30例，给予乳酸钙0．5／d，治疗组30例，在对照组基础上每日给予维生素D80015口服．测定两组患儿治疗前后的骨代谢指标：血清I型前胶原羧基端前肽（PICP）、血清骨钙蛋白（BGP）、总碱性磷酸酶（AKP）、钙和磷水平及骨密度（BMD）。结果治疗3周后，对照组患儿的PICP、BGP、AKP、钙、BMD较治疗前明显下降（P〈0．01），磷较治疗前明显上升（P〈0．01），而治疗组差异无统计学意义（P〉0．05）。结论对照组患儿治疗后成骨细胞合成明显受抑制，骨密度减低，联合应用维生素D后成骨细胞合成无明显抑制．骨密度无明显变化。Objective To investigate the effects of glucocorticoids on bone density and osteoblasts of children with acute idiopathic thrombocytopenic purpura （ITP） and the changes of indicators after application of vitamin D. Methods Patients were divided into two groups, the control group were treated with glucocorticoid and oral calcium lactate 0.5/day（ daily prednisone 2 mg/kg for 3 weeks, n = 20）, the treatment group were treated with glucocorticoid, oral calcium lactate 0.5/day and oral vitamin D 800 IU/day （n = 20）. At the same time, the levels of bone metabolism indexes of serum PICP, BGP, AKP, Ca and P were measured. Results After 3 weeks treatment, BGP, PICP, AKP, Ca,BMD in the control group significantly decreased than before treatment （ P 〈 0.05 ）, phosphorus increased obviosly （ P 〈 0.05 ）, and there was no significant difference in the treatment group （ P 〉 0. 05 ）. Conclusions The bone density and osteoblast synthesis of acute idiopathic thrombocytopenic purpura children treated with glucocorticoid significantly decrease but when combined with vitamin D, synthesis of bone cells is not inhibited, there is no significant change in bone density.

关 键 词：糖皮质激素 特发性血小板减少性紫癜 骨密度 成骨细胞 维生素D 

分 类 号：R72[医药卫生—儿科]