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目的：了解吸入皮质类固醇治疗对成人骨骼的不良影响。方法：６３例男性分为２组：（１）吸入皮质类固醇治疗组２１例，其中 ４例为哮喘患者，１７例为 ＣＯＰＤ患者，吸入二丙酸倍氯米松（ＢＤＰ）６００～８００ ｕｇ／ｄ治疗豆个月至 ３年。（２）未吸入皮质类固醇治疗的ＣＯＰＤ患者４２例。３０例健康男性作为正常对照组。３组对象均用双能Ｘ线吸收骨密度仪（ＤＥＸＡ）行腰椎（Ｌ２、Ｌ３、Ｌ４、）和近端股骨（股骨颈、大转子、Ｗａｒｄ氏三角）骨密度（ＢＭＤ）测定，ＥＬＩＳＡ测定血清骨钙素（ＢＧＰ）、抗酒石酸盐酸性磷酸酶（ＴＲＡＰ）和晨尿胶原吡啶并酚（ＰｙＤ）、脱氧胶原吡啶并酚（Ｄ—ＰｙＤ）。结果：吸入类固醇治疗组与非类固醇治疗组比较，腰椎和近端股骨ＢＭＤ值均无显著差异。治疗组ＢＧＰ（５．５６±１．９７ ｎｇ／ｍｌ）较非治疗组（６．９１± ２．７０ｎｇ／ｍｌ）降低（Ｐ＜０．０５），治疗组ＴＲＡＰ（４．７８±０．７２ ｕ／Ｌ）较非治疗组（４．４１±０．６１ ｕ／Ｌ）升高（Ｐ＜０．０５）。结论：吸入ＢＤＰ治疗对成人哮喘和ＣＯＰＤ的近期骨密度值无明显影响，但可造成成骨功能受抑和破骨功能提高。
Objectives: To understand the adverse effects of inhaled corticosteroids on adult bones. Methods: Sixty-three men were divided into two groups: (1) In 21 patients with inhaled corticosteroids, 4 were asthmatic and 17 were COPD patients. BDP was 600-800 μg / d Treatment of beans from months to 3 years. (2) 42 patients with COPD who did not inhaled corticosteroids. 30 healthy men as normal control group. The BMD of lumbar spine (L2, L3, L4) and proximal femur (femoral neck, greater trochanter and Ward’s triangle) were measured by dual energy X-ray absorptiometry (DEXA) Serum BGP, TRAP, and morning urine collagen PyD, deoxygenated collagen pyridinol (D-PyD). Results: BMD of lumbar spine and proximal femur were not significantly different between inhaled steroid group and non-steroid treated group. BGP in treatment group (5.56 ± 1.97 ng / ml) was lower than that in non-treatment group (6.91 ± 2.70 ng / ml) (P <0.05), and TRAP in treatment group was 4.78 ± 0.72 u / L) than non-treatment group (4.41 ± 0.61 u / L) (P <0.05). Conclusion: Inhaled BDP has no significant effect on the recent BMD of adult asthma and COPD, but it can result in the suppression of osteogenesis and the improvement of osteoclast function.