一项为期两年的随机双盲研究，比较倍氯米松和氟替卡松对骨密度的影响。JF欧洲呼吸杂志JO Eur Respir J FD欧洲呼吸学会SP 1267 OP 1275 VO 13 IS 6 A1 Egan, JJ A1 Maden, C A1 Kalra, S A1 Adams, JE A1 Eastell, R A1 Woodcock，188bet官网地址AA YR 1999 UL //www.qdcxjkg.com/content/13/6/1267.abstract AB横断面研究表明，接受高剂量吸入糖皮质激素和间歇性口服糖皮质激素的哮喘患者骨量减少。这项为期2年的前瞻性研究旨在评估接受高剂量吸入糖皮质激素患者的骨密度变化。患者(n = 33)(男性18-50岁，女性18-40岁)吸入皮质类固醇1000 - 2000微克x天(-1)，以双盲方式随机分为丙酸氟替卡松(FP) 1000微克x天(-1)或二丙酸倍氯米松(BDP) 2000微克x天(-1)。同时，研究了三个相同年龄范围的开放对照组:接受低剂量吸入糖皮质激素(<或=400微克x天(-1))的哮喘患者(n = 8) (A组);慢性、严重哮喘患者(n = 8)接受口服皮质类固醇(>或= 10mg x天(-1)(B组);健康未治疗志愿者(n = 7) (C组)。脊柱骨密度扫描(定量计算机断层扫描(QCT);在基线和治疗6、12和24个月后分别进行脊柱、股骨颈双x线吸收仪和前臂单光子吸收仪)。每3个月收集一次骨生化标志物测定(血清骨钙素、骨碱性磷酸酶、1型胶原前羧基末端前肽、去氧吡啶啉和1型胶原c末端肽)。FP 15例(平均年龄36岁，男性6例)，BDP 9例(平均年龄33岁，男性5例); completed the study. At 0 months, mean bone mineral density (BMD) was lower in patients receiving inhaled corticosteroids (both low dose and high dose) than in normal volunteers. In the FP-treated group, mean vertebral trabecular BMD quantitative computed tomography remained stable with no evidence of decline, whereas there was some decline in the BDP-treated group. The treatment difference between FP and BDP was statistically significant in favour of FP for quantitative computed tomography measurements after 12 months (p = 0.006) and 24 months (p = 0.004). This study suggests that over 24 months, changes in bone density are minimal in patients on high-dose inhaled corticosteroids.