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目的探讨泼尼松导致骨质疏松的发病机理。方法用患儿自身对照形式将26例原发性肾病(单纯性肾病18例,肾炎性肾病8例)分激素治疗前组和激素足量治疗组两组,测定患儿血清骨钙蛋白、血钙和24h尿钙水平。结果血清骨钙水平在应用激素治疗4～8周后明显低于激素治疗前P<0.001),24h尿钙明显升高(P<0.001),血钙无明显变化;激素治疗后血钙与24h尿钙呈显著负相关(r=-0.536P<0.05)。结论肾病综合征患儿应用泼尼松治疗后骨合成明显下降,24h尿钙排泄增加的原因是骨吸收增强所致。
Objective To explore the pathogenesis of prednisone-induced osteoporosis. Methods Twenty-six patients with primary nephropathy (18 cases of simple nephropathy and 8 cases of nephritic nephropathy) were divided into two groups before treatment with hormones and adequate treatment group. Serum osteocalcin and serum Calcium and 24h urinary calcium levels. Results The level of serum calcium was significantly lower than that before hormone treatment (P <0.001), and increased significantly (P <0.001) 24 h after treatment with hormone. Urinary calcium was significantly negatively correlated (r = -0.536P <0.05). Conclusion The nephrotic syndrome patients treated with prednisone significantly decreased bone formation, 24-hour urinary calcium excretion increased due to increased bone resorption.