国际口腔医学杂志 ›› 2017, Vol. 44 ›› Issue (1): 63-68.doi: 10.7518/gjkq.2017.01.014
张雪峰,王冏珂,曾昕,陈谦明
Zhang Xuefeng, Wang Jiongke, Zeng Xin, Chen Qianming.
摘要: 糖皮质激素是治疗寻常型天疱疮的首选药物。但糖皮质激素治疗可能引起血糖升高、血压升高、脂质代谢异常、钙的吸收代谢及骨形成异常、感染、肾上腺皮质功能减退、心血管问题,及糖尿病、高血压、骨质疏松、骨坏死等不良反应。因此,了解糖皮质激素的不良反应并掌握相应的应对手段对临床治疗口腔寻常型天疱疮十分必要。本文将综述口服糖皮质激素治疗口腔寻常型天疱疮过程中可能出现的不良反应及其应对策略。
中图分类号:
[1] Martin LK, Werth VP, Villaneuva EV, et al. A systematic review of randomized controlled trials for pemphigus vulgaris and pemphigus foliaceus[J]. J Am Acad Dermatol, 2011, 64(5):903-908. [2] Scully C, Mignogna M. Oral mucosal disease: pem-phigus[J]. Br J Oral Maxillofac Surg, 2008, 46(4): 272-277. [3] Yeh SW, Sami N, Ahmed RA. Treatment of pem-phigus vulgaris: current and emerging options[J]. Am J Clin Dermatol, 2005, 6(5):327-342. [4] Scully C, Paes De Almeida O, Porter SR, et al. Pem-phigus vulgaris: the manifestations and long-term management of 55 patients with oral lesions[J]. Br J Dermatol, 1999, 140(1):84-89. [5] Mignogna MD, Lo Muzio L, Mignogna RE, et al. Oral pemphigus: long term behaviour and clinical response to treatment with deflazacort in sixteen cases[J]. J Oral Pathol Med, 2000, 29(4):145-152. [6] Fardet L, Fève B. Systemic glucocorticoid therapy: a review of its metabolic and cardiovascular adverse events[J]. Drugs, 2014, 74(15):1731-1745. [7] Uchida K, Nakajima H, Miyazaki T, et al. Effects of alendronate on bone metabolism in glucocorticoid-induced osteoporosis measured by 18F-fluoride PET: a prospective study[J]. J Nucl Med, 2009, 50(11): 1808-1814. [8] Panthakalam S, Bhatnagar D, Klimiuk P. The preva-lence and management of hyperglycaemia in patients with rheumatoid arthritis on corticosteroid therapy [J]. Scott Med J, 2004, 49(4):139-141. [9] Uzu T, Harada T, Sakaguchi M, et al. Glucocor-ticoid-induced diabetes mellitus: prevalence and risk factors in primary renal diseases[J]. Nephron Clin Pract, 2007, 105(2):c54-c57. [10] Reynolds RM, Labad J, Sears AV, et al. Glucocor-ticoid treatment and impaired mood, memory and metabolism in people with diabetes: the Edinburgh Type 2 Diabetes Study[J]. Eur J Endocrinol, 2012, 166(5):861-868. [11] Lansang MC, Hustak LK. Glucocorticoid-induced diabetes and adrenal suppression: how to detect and manage them[J]. Cleve Clin J Med, 2011, 78(11): 748-756. [12] Committee for Guidelines for the Management of Pemphigus Disease, Amagai M, Tanikawa A, et al. Japanese guidelines for the management of pemphi-gus[J]. J Dermatol, 2014, 41(6):471-486. [13] Bevier WC, Zisser HC, Jovanovic L, et al. Use of continuous glucose monitoring to estimate insulin requirements in patients with type 1 diabetes mellitus during a short course of prednisone[J]. J Diabetes Sci Technol, 2008, 2(4):578-583. [14] Buehring B, Viswanathan R, Binkley N, et al. Gluco-corticoid-induced osteoporosis: an update on effects and management[J]. J Allergy Clin Immunol, 2013, 132(5):1019-1030. [15] Suzuki Y, Nawata H, Soen S, et al. Guidelines on the management and treatment of glucocorticoid-induced osteoporosis of the Japanese Society for Bone and Mineral Research: 2014 update[J]. J Bone Miner Metab, 2014, 32(4):337-350. [16] Hoes JN, Jacobs JW, Boers M, et al. EULAR evidence-based recommendations on the manage-ment of sys-temic glucocorticoid therapy in rheumatic diseases [J]. Ann Rheum Dis, 2007, 66(12):1560-1567. [17] Fardet L, Petersen I, Nazareth I. Monitoring of pa-tients on long-term glucocorticoid therapy: a popula-tion-based cohort study[J]. Medicine(Baltimore), 2015, 94(15):e647. [18] Chan KL, Mok CC. Glucocorticoid-induced avascu-lar bone necrosis: diagnosis and management[J]. Open Orthop J, 2012, 6:449-457. [19] Assouline-Dayan Y, Chang C, Greenspan A, et al. Pathogenesis and natural history of osteonecrosis[J]. Semin Arthritis Rheum, 2002, 32(2):94-124. [20] Migita K, Sasaki Y, Ishizuka N, et al. Glucocorticoid therapy and the risk of infection in patients with newly diagnosed autoimmune disease[J]. Medicine (Baltimore), 2013, 92(5):285-293. [21] McDougall R, Sibley J, Haga M, et al. Outcome in patients with rheumatoid arthritis receiving predni-sone compared to matched controls[J]. J Rheumatol, 1994, 21(7):1207-1213. [22] Morand EF. Corticosteroids in the treatment of rheu-matologic diseases[J]. Curr Opin Rheumatol, 2000, 12(3):171-177. [23] Stuck AE, Minder CE, Frey FJ. Risk of infectious complications in patients taking glucocorticosteroids [J]. Rev Infect Dis, 1989, 11(6):954-963. [24] Fardet L, Cabane J, Kettaneh A, et al. Corticosteroid-induced lipodystrophy is associated with features of the metabolic syndrome[J]. Rheumatology: Oxford, 2007, 46(7):1102-1106. [25] Sato A, Funder JW, Okubo M, et al. Glucocorticoid-induced hypertension in the elderly. Relation to serum calcium and family history of essential hyper-tension[J]. Am J Hypertens, 1995, 8(8):823-828. [26] Panoulas VF, Douglas KM, Stavropoulos-Kalinoglou A, et al. Long-term exposure to medium-dose gluco-corticoid therapy associates with hypertension in patients with rheumatoid arthritis[J]. Rheumato-logy: Oxford, 2008, 47(1):72-75. [27] Carli L, Tani C, Querci F, et al. Analysis of the preva-lence of cataracts and glaucoma in systemic lupus erythematosus and evaluation of the rheumatologists’ practice for the monitoring of glucocorticoid eye toxicity[J]. Clin Rheumatol, 2013, 32(7):1071-1073. [28] Fel A, Aslangul E, Le Jeunne C. Eye and cortico-steroid’s use[J]. Presse Med, 2012, 41(4):414-421. [29] Zode GS, Sharma AB, Lin X, et al. Ocular-specific ER stress reduction rescues glaucoma in murine glucocorticoid-induced glaucoma[J]. J Clin Invest, 2014, 124(5):1956-1965. [30] Johnson LN, Soni CR, Johnson MA, et al. Short-term use of inhaled and intranasal corticosteroids is not associated with glaucoma progression on optical coherence tomography[J]. Eur J Ophthalmol, 2012, 22(5):695-700. [31] Olsen M, Christensen S, Riis A, et al. Preadmission use of systemic glucocorticoids and 30-day mortality following bleeding peptic ulcer: a population-based cohort study[J]. Am J Ther, 2010, 17(1):23-29. [32] van der Goes MC, Jacobs JW, Boers M, et al. Moni-toring adverse events of low-dose glucocorti-coid therapy: EULAR recommendations for clinical trials and daily practice[J]. Ann Rheum Dis, 2010, 69(11): 1913-1919. [33] Zaki SM, Mohamed EA. Effect of glucocorticoids on indomethacin-induced gastric ulcer in the adult male albino rat-histological, morphometric and elec-tron microscopy study[J]. Arch Med Sci, 2014, 10 (2):381-388. [34] Brenner PF. Differential diagnosis of abnormal ute-rine bleeding[J]. Am J Obstet Gynecol, 1996, 175(3 Pt 2):766-769. [35] Shwayder JM. Pathophysiology of abnormal uterine bleeding[J]. Obstet Gynecol Clin North Am, 2000, 27(2):219-234. [36] Warner P, Weir CJ, Hansen CH, et al. Low-dose dexamethasone as a treatment for women with heavy menstrual bleeding: protocol for response-adaptive randomised placebo-controlled dose-finding parallel group trial(DexFEM)[J]. BMJ Open, 2015, 5(1):e006837. [37] Duru N, van der Goes MC, Jacobs JW, et al. EULAR evidence-based and consensus-based recommen-dations on the management of medium to high-dose glucocorticoid therapy in rheumatic diseases[J]. Ann Rheum Dis, 2013, 72(12):1905-1913. [38] Fardet L, Petersen I, Nazareth I. Prevalence of long-term oral glucocorticoid prescriptions in the UK over the past 20 years[J]. Rheumatology(Oxford), 2011, 50(11):1982-1990. [39] Overman RA, Yeh JY, Deal CL. Prevalence of oral glucocorticoid usage in the United States: a general population perspective[J]. Arthritis Care Res(Hobo-ken), 2013, 65(2):294-298. [40] Fardet L, Cabane J, Lebbé C, et al. Incidence and risk factors for corticosteroid-induced lipodystrophy: a prospective study[J]. J Am Acad Dermatol, 2007, 57(4):604-609. |
[1] | 肖妍荻, 杨华梅, 但红霞. 抗肿瘤靶向药物相关不良反应在口腔中的表现及处理对策[J]. 国际口腔医学杂志, 2018, 45(2): 140-144. |
[2] | 王婷, 葛少华. 氧化石墨烯在生物医学领域方面应用的研究进展[J]. 国际口腔医学杂志, 2017, 44(5): 591-595. |
[3] | 王冏珂,张雪峰,陈谦明,曾昕. 口腔黏膜寻常型天疱疮的口服糖皮质激素治疗:剂量与疗程[J]. 国际口腔医学杂志, 2017, 44(1): 69-74. |
[4] | 马会强 李阳 刘国慧. 咪达唑仑治疗口腔恐惧症的不良反应[J]. 国际口腔医学杂志, 2016, 43(1): 66-. |
[5] | 崔鸢 代青芸 冯慧 江潞. 萎缩性舌炎病因的研究进展[J]. 国际口腔医学杂志, 2015, 42(4): 442-445. |
[6] | 张晓雪 龚彩霞. 50 例咽成形术后氧气雾化吸入不良反应的观察及护理干预[J]. 国际口腔医学杂志, 2012, 39(6): 723-725. |
[7] | 石慧综述 李志华审校. 二膦酸盐在正畸治疗研究中的进展[J]. 国际口腔医学杂志, 2012, 39(4): 533-536. |
[8] | 李桦综述 胡敏审校. 含镍合金在正畸治疗中生物安全性的研究进展[J]. 国际口腔医学杂志, 2012, 39(2): 233-236. |
[9] | 万书健,苏剑生,. 牙科合金引起不良反应的机制[J]. 国际口腔医学杂志, 2006, 33(05): 396-397. |
[10] | 江潞,陈谦明. 天疱疮的糖皮质激素治疗[J]. 国际口腔医学杂志, 2004, 31(06): 478-480. |
|