High risk of osteonecrosis of the femoral head in autoimmune disease patients showing no immediate increase in hepatic enzyme under steroid therapy
High risk of osteonecrosis of the femoral head in autoimmune disease patients showing no immediate increase in hepatic enzyme under steroid therapy
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DOI：
10.1007/s00296-011-2295-y
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发表时间：
2013-01-01
影响因子：
4
通讯作者：
Matsumoto, Hiroshi
中科院分区：
文献类型：
--
作者：
Okazaki, Shunichiro;Nagoya, Satoshi;Matsumoto, Hiroshi
本研究的目的是确定aids患者类固醇治疗后肝功能与ONF发生率之间的关系。本研究调查了58例接受大剂量全身类固醇治疗的AID患者，以确定在类固醇诱导的ONF发生的精确时间点，肝功能参数与类固醇诱导的ONF之间是否存在相关性。根据MRI表现将患者分为两组：ONF （n = 31）和non-ONF （n = 27）。ONF组在类固醇治疗开始后4周内AST、ALT或LDH均未升高。相比之下，非onf组在所有这些参数上都显示出立即和显著的增加。在ONF组中，还观察到肝脂肪变性和甘油三酯水平升高。类固醇治疗4周后，两组患者的生化指标无显著差异。在类固醇治疗后ALT和AST没有立即升高的患者是ONF的高危患者。这些发现为类固醇诱导ONF的发病机制提供了重要的见解，并可能促进艾滋病患者预防策略的发展。
Aim of the study is to determine the relationship between liver function and the incidence of ONF after steroid therapy in AID patients. The present study investigated 58 AID patients who had received high-dose systemic steroid therapy to determine whether a correlation exists between parameters of hepatic function and steroid-induced ONF at the precise time-point when steroid-induced ONF develops. The patients were divided into two groups on the basis of MRI findings: ONF (n = 31) and non-ONF (n = 27). The ONF group showed no increase in AST, ALT, or LDH within 4 weeks after the commencement of steroid therapy. By contrast, the non-ONF group showed an immediate and significant increase in all of these parameters. In the ONF group, hepatic steatosis and elevated triglyceride levels were also observed. Following 4 weeks of steroid therapy, there were no significant differences in biochemical data between two groups. Patients showing no immediate increase in ALT and AST in response to steroid therapy were at high risk of ONF. These findings provide important insights into the pathogenesis of steroid-induced ONF and may facilitate the development of prevention strategies in patients with AID.