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目的探讨糖皮质激素(GC)对肾病综合征(NS)患儿骨代谢的影响。方法选择30例NS患儿为NS组,予口服泼尼松2 mg.kg-1.d-1,采用中、长程疗法。治疗前及应用GC治疗4周后采集NS患儿静脉血,并留取晨尿,分别测定血Ⅰ型前胶原羧基末端前肽(PICP)、尿脱氧吡啶啉(DPD)排泄率。健康体检的15名学龄前儿童为健康对照组。结果 NS组患儿GC治疗前血清PICP水平、尿DPD排泄率与健康对照组比较,差异均无统计学意义(Pa>0.05);GC治疗后血清PICP水平较治疗前及健康对照组明显降低、尿DPD排泄率较治疗前及健康对照组明显增高,差异均有统计学意义(Pa<0.05)。结论长期应用GC对NS患儿骨骼代谢有潜在的影响。
Objective To investigate the effect of glucocorticoid (GC) on bone metabolism in children with nephrotic syndrome (NS). Methods Thirty children with NS were selected as the NS group and given prednisone 2 mg.kg-1.d-1 orally. Median and long-term therapy was used. Before treatment and 4 weeks after the application of GC, venous blood was collected from patients with NS and morning urine was collected. The excretion rate of PICP and DPD was determined. Fifteen preschoolers in a physical examination were healthy controls. Results There was no significant difference in the levels of serum PICP and urinary DPD excretion before and after GC treatment in NS group (P> 0.05). The serum PICP levels in GC group were significantly lower than those before treatment and in healthy control group Urine DPD excretion rate was significantly higher than before treatment and healthy control group, the difference was statistically significant (Pa <0.05). Conclusion Long-term use of GC has a potential impact on bone metabolism in children with NS.