Risk period for developing osteonecrosis of the femoral head in patients on steroid treatment
Risk period for developing osteonecrosis of the femoral head in patients on steroid treatment
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DOI：
10.1007/s100670200078
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发表时间：
2002-08-01
影响因子：
3.4
通讯作者：
Wang, GJ
中科院分区：
文献类型：
--
作者：
Koo, KH;Kim, R;Wang, GJ
需要长期使用类固醇的患者有发生骨坏死的风险。然而，股骨头坏死的风险期尚未确定。作者试图确定类固醇治疗后股骨头坏死的发生。我们回顾了四所大学医院激素相关性股骨头坏死患者的病历资料。收集了早期通过磁共振成像（MRI）诊断且平片无阳性结果（循环骨协会研究I期骨坏死）的患者使用类固醇的持续时间和剂量的相关信息。22例患者在协会研究循环骨I期被诊断。男8例，女14例，年龄17 ~ 60岁，平均33岁。类固醇的总剂量，这是使用，直到通过MRI检测到骨坏死的时间，范围从1800至15 505 mg泼尼松龙或其等效物（平均5928 mg）。从开始类固醇治疗到MRI诊断的时间范围为1个月至16个月（平均5.3个月）。22例患者中有21例在开始类固醇治疗后12个月内确诊。在此期间，类固醇治疗的持续时间范围为1个月至12个月（平均4.5个月）。接受长期类固醇治疗的患者可能有12个月的风险期发生股骨头坏死。建议在长期类固醇治疗的第一年内进行密切观察和更积极的筛查，以预防晚期股骨头坏死。
Patients who require long-term steroid use are at risk for the development of osteonecrosis. However, the risk period for developing osteonecrosis of the femoral head has not yet been defined. The authors attempted to determine the onset of osteonecrosis of the femoral head following steroid treatment. Medical record data of patients with steroid-related osteonecrosis of the femoral head from four university hospitals were reviewed. Information was collected regarding the duration and dose of steroid use for patients who were diagnosed at the early stage by magnetic resonance imaging (MRI) without positive findings on plain radiographs (Association Research Circulation Osseous stage I osteonecrosis). Twenty-two patients were diagnosed at Association Research Circulation Osseous stage I. There were eight male and 14 female patients ranging in age from 17 to 60 years (mean 33). The total dose of steroid, which was used until the time of detection of osteonecrosis by MRI, ranged from 1800 to 15 505 mg prednisolone or its equivalent (mean 5928 mg). The period from the start of steroid treatment to the diagnosis by MRI ranged from 1 month to 16 months (mean 5.3 months). Twenty-one of 22 patients were diagnosed within 12 months of the initiation of steroid treatment. The duration of steroid treatment within this period ranged from 1 month to 12 months (mean 4.5 months). There may be a risk period of 12 months for developing femoral head osteonecrosis in patients receiving long-term steroid treatment. Close observation and more aggressive screening are recommended within the first year of long-term steroid treatment to prevent advanced osteonecrosis of the femoral head.