激素的使用方法不同，引起骨疏松也不一样 摘要：因激素对性激素和维生素D、钙平衡以及骨细胞和骨基质均有不良影响，故口服激素与骨折危险性增高有关。但口服激素引起的骨折风险增高似乎更与每日激素量相关，而与累积剂量关系小，即每日小剂量似乎比间断大剂量影响更大。眼、耳或皮肤及直肠等局部用激素与骨折危险性增高无关。除高剂量吸入激素外，常规量吸入激素与骨折风险增高也无关。局部使用激素比口服激素对预防骨折更有优势。至于间断性用激素方案的疗效是否与每日服激素方案一样，是否能避免或减少骨疏松骨折的风险，还需进一步的研究。

附原文：Oral corticosteroids are associated with an increased risk of fractures from negative effects on sex steroids and vitamin D with a negative calcium balance, together with negative effects on the bone cells and the bone matrix. However, the increase in fracture risk with oral corticosteroids seems more linked to daily than to cumulative dose. A small daily dose may consequently be more detrimental than a large cumulative dose given as intermittent doses. Topical corticosteroids administered locally in the eyes, ears, in the mouth, on the skin, and rectally are not associated with an increased risk of fractures. Inhaled corticosteroids are not associated with an increased risk of fractures, except at very high doses that are much higher than the doses usually administered. With regard to the prevention of fractures, the use of topical corticosteroids may be preferred over oral administration where feasible. More research is needed to determine practically applicable intermittent dosing regimens for corticosteroids, replacing daily administration, to assess if this can have the same beneficial clinical effect but avoid, or at least reduce, the risk of osteoporosis and fractures.

摘自：Vestergaard P.Skeletal effects of systemic and topical corticosteroids. Curr Drug Saf, 2008,3(3):190-3.