Glucocorticoid-Induced Bone Disease
Glucocorticoid-Induced Bone Disease
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DOI：
10.1056/nejmcp1012926
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发表时间：
2011-07-07
影响因子：
158.5
通讯作者：
Weinstein, Robert S.
中科院分区：
文献类型：
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作者：
Weinstein, Robert S.
一位55岁女性，患有严重的持续性哮喘，过去3个月需要糖皮质激素治疗。她的药物包括沙丁胺醇、吸入性氟替卡松和沙美特罗、孟鲁司特和泼尼松（每天10毫克）。在过去，她接受了几个间歇性疗程的泼尼松，剂量为每天15毫克或更高。她的体重是45.5公斤（100磅），身高157.5厘米（62英寸）;体重指数（体重（千克）除以身高（米）的平方）为18。呼气时可听到分散的喘息声。脊椎叩诊和胸腔压迫的表现不明显。她的情况应该如何评估和管理，以尽量减少骨折的风险？
A 55-year-old woman with severe, persistent asthma requiring glucocorticoid therapy for the past 3 months presents for care. Her medications include albuterol, inhaled fluticasone with salmeterol, montelukast, and prednisone (at a dose of 10 mg per day). In the past, she received several intermittent courses of prednisone at a dose of 15 mg or more per day. Her weight is 45.5 kg (100 lb), and her height 157.5 cm (62 in.); the body-mass index (the weight in kilograms divided by the square of the height in meters) is 18. Scattered wheezing is heard during expiration. Findings on vertebral percussion and rib-cage compression are unremarkable. How should her case be evaluated and managed to minimize the risk of fractures?