目的了解中国服用糖皮质激素风湿病患者骨质疏松的发病情况和诊疗现状,以期引起对骨质疏松防治的重视。方法 2012年11月1日至2013年1月31日,在全国46家风湿病专科医院对3 136例曾经或正在服用糖皮质激素的风湿病患者进行临床资料、用药情况及骨量调查,了解骨量减少和骨质疏松的发生率。结果 (1)所有调查患者中,主要病种为类风湿关节炎(1 069例)和系统性红斑狼疮(983例)。3 136例患者中90%存在骨量减少或骨质疏松,其中骨质疏松的发生率为41.4%。44.7%的患者在调查当时糖皮质激素用量(等效于泼尼松)>7.5 mg/d,调查当时糖皮质激素剂量≤2.5 mg/d者仍有58.5%存在骨质疏松。(2)随着年龄增加,骨质疏松及骨折的发病率明显增加;小于30岁的患者骨量减少和骨质疏松总发生率为74.4%。(3)女性风湿病患者骨密度异常比例高于男性,平均停经年龄低于正常人群(45.8岁)。(4)抗骨质疏松药物使用不规范,32.7%的患者从未预防性给予抗骨质疏松药物治疗,在T<-2.5的患者中,35.6%未给予预防性抗骨质疏松治疗。主要用药为钙和维生素D,20.9%的患者仅给予钙剂单独治疗,仅有4%使用膦酸盐类药物。结论我国应用糖皮质激素的风湿病患者骨量减少和骨质疏松发生率明显增高,且预防性用药不规范。 Objective To understand the incidence and diagnosis and treatment of osteoporosis in Chinese patients taking glucocorticoid rheumatism in order to arouse the importance of prevention and treatment of osteoporosis. Methods From November 1, 2012 to January 31, 2013, the clinical data, medication status and bone mass of 3 136 rheumatic patients who had or were taking glucocorticoid were investigated in 46 rheumatological hospitals across China. Osteoporosis and the incidence of osteoporosis. Results (1) Among the surveyed patients, the main diseases were rheumatoid arthritis (1 069 cases) and systemic lupus erythematosus (983 cases). 90% of 136 patients had osteopenia or osteoporosis, with a prevalence of osteoporosis of 41.4%. 44.7% of patients were surveyed glucocorticoid dose (equivalent to prednisone)> 7.5 mg / d at the time of the survey was still 58.5% glucocorticoid dose of osteoporosis. (2) The incidence of osteoporosis and fractures increased significantly with age. The overall incidence of osteopenia and osteoporosis in patients younger than 30 years old was 74.4%. (3) The prevalence of abnormal BMD in female patients with rheumatism was higher than that in males, and the average age at menopause was lower than that in normal people (45.8 years). (4) The use of anti-osteoporosis drugs is not standardized. 32.7% of the patients were never given prophylactic anti-osteoporosis drugs. Of the patients with T <-2.5, 35.6% did not receive preventive anti-osteoporosis treatment. The main medication for calcium and vitamin D, 20.9% of patients treated with calcium alone, only 4% of the use of phosphonates. Conclusion The incidence of osteopenia and osteoporosis in patients with rheumatoid arthritis who are treated with glucocorticoids in our country is significantly increased, and the preventive medication is not standardized.