用多位点定量超声对克罗恩病患者进行纵向骨监测

作     者：Zadik Z. Sinai T. Zung A. Reifen R. 陈瑜 

作者机构：Pediatric Endocrine Unit Kaplan Medical Center Rehovot 76100 Israel Dr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2005年第1卷第7期

页      面：47-48页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：克罗恩病 定量超声 多位点 疾病活动度 峰值骨量 氧甲氢龙 骨质疏松 疾病缓解期 食物成分 血清铁 

摘      要：Background: Crohn’ s disease (CD) is characterized, among other features, by intestinal malabsorption of miner als, vitamins,and various food ingredients. This may cause a suboptimal peak bone mass and thereby susceptibility to osteoporosis at an early age. Objective: Longitudinal measurement of bone in CD during active disease and during remissi on. Design: We evaluated 24 patients with CD (16 males) 14 to 16 years of age lo ngitudinally, every 3 months over 12 months, for disease activity. Longitudinal follow- up by quantitative ultrasound measurement using a bone sonometer (Sunli ght Omnisense, Tel Aviv, Israel) that obtains axial speed of sound (SOS) was als o performed. Eight of the CD patients were in remission (R- CD), characterized by accelerated weight and height gain and near- normal erythrocyte sedimentatio n rate and serum iron. Eight patients had active CD(A- CD), and 8 patients were under treatment with oxandrolone. Results: By two- way repeated- measures ana lysis of variance, the change in SOS Z- score of tibia at 0, 6, and 12 months w as as follows: - 0.5 ± 0.2 to - 0.3 ± 0.2, - 0.6 ± 0.2 to - 1.0 ± 0. 5 and - 0.6 ± 0.2 to - 0.4 ± 0.2 in the remission, active disease, and oxa ndrolone- treated groups, respectively (P 0.001). Similarly, the change in SO S Z- score of radius during the study was as follows: - 0.5 ± 0.3 to - 0.6 ± 0.3, - 0.6 ± 0.3 to - 1.0 ± 0.3 and - 0.6 ± 0.2 to - 0.4 ± 0.2 i n the remission, active disease, and oxandrolone- treated groups, respectively (P 0.001). While a small change over time in patients in remission was noted, SOS decreased in patients with active disease and increased in oxandrolone- tre ated patients. Despite the fact that SOS remained in the normative range in all patients, a clear deterioration was demonstrated for patients with active diseas e. Conclusions: We conclude that longitudinal follow- up of patients with activ e disease may detect an early pattern of deterioration in quality of bone.