碳酸钙联合维生素K对GIOP患儿骨代谢指标、Th1细胞因子及安全性的影响  

Effect of calcium carbonate combined with vitamin K on bone metabolism indexes,Th1 cytokines and safety in children with glucocorticoid-induced osteoporosis

作　　者：曲艳春[1] 钱霞 宋颖颖 Qu Yanchun;Qian Xia;Song Yingying(Department of Pharmacy,Shanxi Provincial Children’s Hospital(Maternal and Child Health Hospital),Taiyuan 030013,China;Department of Endocrinology,Second People’s Hospital of Datong City,Datong 037008,China)

机构地区：[1]山西省儿童医院(妇幼保健院)药剂科,太原030013 [2]大同市第二人民医院内分泌科,大同037008

出　　处：《中华内分泌外科杂志》2023年第5期573-577,共5页Chinese Journal of Endocrine Surgery

基　　金：山西省自然科学基金(201901D211538)。

摘　　要：目的探讨碳酸钙联合维生素K对糖皮质激素性骨质疏松症(glucocorticoids-induced osteoporosis,GIOP)患儿骨代谢指标、Th1细胞因子及安全性的影响。方法本研究纳入96例GIOP患儿进行研究,按随机数字表法分为对照组与观察组,每组各48例。对照组使用碳酸钙治疗,观察组使用碳酸钙联合维生素K治疗。对比分析两组患儿治疗前后骨代谢指标血清I型胶原氨基前端肽(type I procollagen amino-terminal peptide,PINP)、血清β-胶原特殊序列(βcollagen special sequence,β-CTX)、骨钙素(osteocalcin,BGP)、血清骨碱性磷酸酶(bone alkaline phosphatase,BALP)、Th1细胞因子γ干扰素(interferon-γ,IFN-γ)降低,白细胞介素2(interleukin-2,IL-2)水平及不良反应情况。结果两组患者一般资料比较差异无统计学意义(均P>0.05)。与治疗前比较,两组治疗后股骨颈骨密度均增强,且观察组(-1.02±0.49)较对照组(-1.52±0.65)改善更明显(t=4.26,P<0.001)。与治疗前比较,两组治疗后PINP、β-CTX、BGP和BALP等水平降低,且相对于对照组(PINP:31.65±6.58;β-CTX:0.34±0.05;BGP:4.95±1.28;BALP:40.54±7.84),观察组治疗后各指标(PINP:26.54±7.06;β-CTX:0.24±0.03;BGP:3.05±1.09;BALP:35.96±7.02)改善更显著(t=3.67,P<0.001;t=11.88,P<0.001;t=7.83,P<0.001;t=3.02,P<0.003)。与治疗前比较,两组治疗后IL-2水平提高但IFN-γ水平降低,且相对于对照组(IL-2:163.89±30.85;IFN-γ:196.61±21.05),观察组治疗后IL-2水平(198.32±32.14)更高且IFN-γ水平(163.25±18.43)更低(t=5.35,P<0.001;t=8.26,P<0.001)。两组不良反应发生率比较差异无统计学意义(χ^(2)=0.15,P=0.695)。结论碳酸钙联合维生素K治疗GIOP患儿,可改善患儿骨代谢指标、Th1细胞因子水平,临床治疗效果良好。Objective To investigate the effect of calcium carbonate combined with vitamin K on bone metabolism indexes,Th1 cytokines and safety in children with glucocorticoid-induced osteoporosis.Methods A total of 96 children with glucocorticoid-induced osteoporosis were enrolled in this study.They were randomly divided into control group and study group,48 cases in each group.The control group was treated with calcium carbonate,and the study group was treated with calcium carbonate combined with vitamin K.The bone metabolism index serum total bone typeⅠcollagen N-terminal peptide was compared between the two groups before and after treatment.PINP),serumβ-Carboxy I terminal peptide(β-CTX),osteocalcin(osteocalcin,P<0.05),and serumβ-CTX.BGP),serum bone alkaline phosphatase(BALP),Th1 cytokine interferon-γ(IFN-γ),interleukin-2(IL-2)levels and adverse reactions were also observed.Results There was no statistical significance in the general data of the two groups(all P>0.05).Compared with that before treatment,bone mineral density of femoral neck increased in both groups after treatment,and the improvement in the study group(-1.02±0.49)was more significant than that in the control group(-1.52±0.65)(t=4.26,P<0.001).Compared with those before treatment,the levels of PINP,β-CTX,BGP and BALP in 2 groups after treatment were decreased,and compared with those of the those of the control group(PINP:31.65±6.58;β-CTX:0.34±0.05;BGP:4.95±1.28;BALP:40.54±7.84),all indexes of the study group after treatment(PINP:26.54±7.06;β-CTX:0.24±0.03;BGP:3.05±1.09;BALP:35.96±7.02)improved significantly(t=3.67,P<0.001;t=11.88,P<0.001;t=7.83,P<0.001;t=3.02,P<0.003).Compared with that before treatment,IL-2 level was increased while IFN-γlevel was decreased in both treatment groups.Additionally,in comparison to the control group(IL-2:163.89±30.85;IFN-γ:196.61±21.05),IL-2 level(198.32±32.14)was higher and the IFN-γlevel(163.25±18.43)was lower in the study group after treatment(t=5.35,P<0.001;t=8.26,P<0.001).The incidence of advers

关 键 词：碳酸钙 维生素K 糖皮质激素性骨质疏松症 骨代谢 

分 类 号：R725.8[医药卫生—儿科]