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題名 | Influence of Steroids Therapy on Carboxyterminal Propeptide of Type I Procollagen (PICP) and Carboxyterminal Pyridinoline Cross-Linked Telopeptide of Type I Collagen (ICTP) in Young Male with Nephrotic Syndrome=評估接受類固醇治療之年輕男性腎病症候群對其骨質合成及分解指標之影響 |
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作者 | 陳金順; 朱柏齡; 林石化; 郭建偉; 林裕峰; | 書刊名 | 醫學研究 |
卷期 | 20:3 1999.12[民88.12] |
頁次 | 頁124-132 |
分類號 | 415.74 |
關鍵詞 | 類固醇; 骨質代謝指標; 腎病症候群; 年輕男性; Steroid; PICP; ICTP; Nephrotic syndrome; Young male; |
語文 | 英文(English) |
中文摘要 | 類固醇是治療腎病症候群之主要方法之一。長期以來類固醇引起的骨頭病變,一直受到廣泛討論,然而這類研究大部分都集中於長期使用類固醇之患者。對於接受短期類固醇治療之腎病症候群患者,其骨頭影響之報導並不多;近年來,由於骨骼代謝指標之進步,臨床上已被使用為骨頭病變追蹤方法之一。我們收集10位第一次診斷為腎病症候群之年輕男性,治療上只接受類固醇及限鹽飲食,並且得到緩解之患者,並確認其先前並無相關骨病變,且在治療中不給予鈣片或活性維他命D。病人皆接受傳統性類固醇治療,並分別在第0、1、4個月時接受抽血檢查;另外,我們也收集10位年紀相仿之健康男性對照組。主要分析Carboxyterminal propetide of type I procollagen (PICP)及Carboxyterminal pyridinoline cross-linked telopeptide of type I collagen (ICTP)分別代表骨質合成及骨質分解,來追蹤類固醇對骨質之影響。另外,也分析副甲狀腺素(iPTH)、游離鈣離子(iCa)、血清白蛋白(ALB)、膽固醇(T.chol)、體重(BW)及每日蛋白尿流失量(DPL)。結果發現:1)PICP₀與PICPс及PICP₄之比較皆不具統計學差異;2)ICTP₀與ICTPс在統計學上之比較是無差異的,但ICTP₄與ICTP₀之比較是具有統計學上明顯之差異(5.34±0.39 μg/l vs. 7.53±0.69 μg/l,p<0.05);所以我們認為,在年輕男性腎病症候群患者,未接受類固醇治療前,其骨合成及骨分解並未受到疾病之影響。而接受短期治療後,類固醇對骨頭之影響主要在於骨分解,而且是局部性而非全身性。 |
英文摘要 | Steroid therapy is often administered for patients with nephritic syndrome. It has been reported that long-term steroid therapy could induce osteoporosis. However, there has been no data regarding the effect of short-term steroid therapy on bone turnover. The objective of this study is to investigate the effect of commonly prescribed doses of steroids on bone markers. Ten male patients (mean age: 21 years old, range: 19-28 years old) with a first attack of idiopathic full-blown nephritic syndrome between 1996 and 1997 were enrolled in this study. They all received standard steroid therapy only, and got complete remission. Patients were assessed before inclusion (0: data at entry) and subsequently at 1 month (1: data at 1 month) and 4 month (4: data at 4 month) after steroid therapy. Serum level of albumin (ALB), total cholesterol (T.chol), daily protein loss (DPL), body weight (BW), serum carboxyterminal propeptide of type I procollagen (PICP), pyridinoline cross linked telopeptide domain of type I collagen (ICTP), intact parathyroid hormone (iPHT) and ionized calcium (iCa) all were measured simultaneously. On the other hard, we also congregated nine healthy age matched male as control group (c: data of control group). Data were expressed as mean ± standard error of mean, and were analyzed by one-way ANOVA and Student's t-test. Our results disclosed that a). PICP₀ showed no significant difference compared with PICPс and PICP₄, but had a trend of increment; b). There was no significant difference between ICTP₀ and ICTP с, but ICTP ₄ was significantly lower than PICP₀ (5.34±0.39μg/l vs. 7.53±0.69, p<0.05); c). Both of baseline data of iPTH and iCa compared with 4 month after treatment showed no significant difference. We conclude that there is no obvious change in bone formation and bone resorption in young male idiopathic nephritic syndrome before steroid treatment, and steroid effect was major in local hormone, but not systemic hormone after receiving short-term steroids treatment. |
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