気管支喘息患者における腰椎海綿骨骨塩量と脊椎圧迫骨折の臨床的特徴 Determinants of trabecular bone mineral density of the lumber spines and vertebral fracture in patients with bronchial asthma

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Abstract

対象は気管支喘息75症例。このうち44例はステロイド依存性難治症例であった。35症例については,0.5年から4年間(平均:2.6±1.3年間)の経時的観察もおこなわれた。これらの症例の骨塩量に影響を及ぼす因子について検討をおこなった。高齢者,女性に有意な低骨塩量を認めた。重回帰分析にて年齢,性別,経口副腎ステロイド投与総量などの項目に骨塩量と有意な関連が認められた。また,35症例中5例に脊椎圧迫骨折が発生し,いずれも骨塩量が低く,高齢者,女性,長期ステロイド内服例であった。これらのことから気管支喘息患者においては,女性,高齢者,長期ステロイド内服例に骨塩量減少や脊椎圧迫骨折のリスクが高いと考えられた。また,ステロイド続発性骨粗鬆症の発生には,ステロイドの現在の一日内服量よりもこれまでの総積算内服量が重要と考えられた。

Clinical risk factors associated with the development of osteoporosis and vertebral fractures were evaluated in patients with asthma in relation to sex, age, and dose of glucocorticoids (GC). In 75 asthmatic patients including 44 steroid-dependent asthma, the bone mineral density (BMD) of the lumber spines was measured by quantitative computed tomography (QCT). Thirty five patients of them were followed up with radiographs over a period of 0.5 to 4 years (average: 2.6±1.3 years). The BMD was significantly lower in older (p<O.01) or female (p<0.05) patients. All the five patients developing vertebral compression fractures were female and more than 64 y.o., and received systemic glucocorticoid (GC) therapy for more than 3 years with a lot of cumulative gramdosage of GC. No significant correlation was demonstrated between the BMD and the dose of systemic GC per day, but multiple regression analysis demonstrated a significant relationship (p<O.o1) between the BMD and lifetime cumulative gramdosage of GC. Multiple regression analysis also demonstrated significant relationships (p<O.01) between the BMD and clinical factors such as age and sex. These results indicates that the bone loss and vertebral fractures of patients with asthma are influenced by the patient's age, sex, and the lifetime cumulative GC dose.

Journal

  • 岡大三朝分院研究報告

    岡大三朝分院研究報告 (68), 45-50, 1997-12

    岡山大学医学部附属病院三朝分院

Codes

  • NII Article ID (NAID)
    120002308467
  • NII NACSIS-CAT ID (NCID)
    AN10430852
  • Text Lang
    ENG
  • Article Type
    departmental bulletin paper
  • ISSN
    0918-7839
  • Data Source
    IR 
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