这5个容易导致股骨头坏死的高危因素,应对的妙招却很简单!

2022-06-16 sle互助圈 网络

SLE患者股骨头坏死的发生率为4.6%~52%[1]。其中,由于激素治疗导致的股骨头坏死的发生率为14.5%。

股骨头坏死和系统性红斑狼疮之间具有密切的关系,根据报道称,SLE患者股骨头坏死的发生率为4.6%~52%[1]。其中,由于激素治疗导致的股骨头坏死的发生率为14.5%[2]。

 

我们都知道,糖皮质激素的使用是导致股骨头坏死的重大因素,但它并不是唯一因素。今天,互助君就和大家科普一下还有哪些是导致股骨头坏死的高危因素。

 

 

贫血

 

股骨头坏死又叫做股骨头缺血性坏死。其病理表现为股骨头内血供中断,导致骨髓成分或骨细胞死亡,继而在骨细胞修复过程中,股骨头结构改变,股骨头塌陷[3]。

 

由此我们可以知道,供血不足是导致股骨头坏死的机制之一,当狼疮患者合并贫血,股骨头的供血不足的几率升高,因此也提高了股骨头坏死的风险。

 

小贴士

 

预防贫血也能在一定程度上预防股骨头坏死,所以建议有贫血的蝶友注意饮食,可以适量多吃红枣、猪血、猪肝来补血,如果贫血严重则需要及时就医,对症治疗哦。

 

激素治疗起始量大于60mg/d

 

大剂量糖皮质激素治疗是无菌性股骨头坏死的肯定危险因素,但是关于确切剂量,目前尚无定论。我国学者指出,激素起始量大于60mg/d和股骨头坏死具有显著的相关性[4]。

 

同时该研究还指出[4],股骨头坏死均发生在激素治疗1月~30月之间,因此可以推测,在排除其他高危因素的前提下,如果激素治疗3年内没有出现股骨头坏死,那么今后出现股骨头坏死的几率也很低。

 

小贴士

 

激素起始量大于60mg/d的蝶友,建议在激素治疗前3年内,提高股骨头坏死的检查频率。

 

 

突然停用激素

 

当减停激素过快时,容易引起狼疮病情反复,还可能出现情绪消沉、呕吐、发热、恶心等症状[5]。这种现象叫做激素撤退综合征。激素撤退综合征可能会导致蝶友免疫系统出现紊乱,从而加重血管炎症,最后引发股骨头坏死

 

小贴士

 

激素停药深受蝶友的关注,切记一定不能自己擅自减药停药,要主治医生评估各项临床指标后再做出调整哦。

 

高脂血症

 

血脂增高时,骨组织内的脂肪随之堆积,血流减少,导致血清游离脂肪酸和前列腺素增加,引发血管炎,使血液处于高凝状态,容易形成微血栓和脂肪栓子,从而堵塞血管,使骨组织发生缺血性坏死[6]。

 

小贴士

 

饮食应该注意控制脂肪摄入,清淡饮食、少吃油腻煎炸烧烤食物。

 

免疫因素

 

研究表明,自身抗体、免疫复合物造成的血管炎是骨坏死的直接原因。其中抗SSB抗体阳性、抗双链DNA阳性、补体C4水平降低也容易导致骨密度降低、引发骨质疏松,甚至进一步导致股骨头坏死[7]。

 

小贴士

 

抗SSB抗体、抗双链DNA、补体C4水平均是狼疮诊断的实验室指标,它们也是股骨头坏死的高危因素,说明狼疮疾病本身也很容易引发股骨头坏死。建议蝶友们规范治疗,遵循医嘱,尽快控制好狼疮活动,也能够有效预防股骨头坏死。

 

怎么诊断股骨头坏死?

 

当蝶友们出现髋关节痛、腹股沟、臀部、大腿、髋关节内旋活动受限且疼痛时,需要警惕股骨头坏死,建议去骨科进行诊断。

 

主要诊断手段有X线检查、MRI检查(即磁共振成像检查、该检查项目不会产生电离辐射,蝶友们不要太担心)、核素骨扫描、CT扫描[8]。具体方式以就诊时医生推荐为准哦。

 

 

股骨头坏死要注意什么?

 

如果蝶友们真的出现股骨头坏死的前兆,建议日常运动锻炼要适度,不要过于剧烈,另外平时可以尽量乘坐电梯,避免上下楼梯,以免加重髋关节压力。饮食上,要注意补充钙和维生素D,少吃高油、高盐、高脂的食物。

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    2023-04-25 redcrab
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    2022-06-16 ms1531565637822789

    贫血吃红枣,补糖吗?

    1

    展开1条回复
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    2022-06-16 ms5000000518166734

    学习学习学习学习学习学习学习学习学习学习xxxx学习学习学习学习学习学习学习学习学习学习学习学习

    0

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    2022-06-16 s海盗

    红枣不补血

    0

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    2022-06-15 millore
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  8. [GetPortalCommentsPageByObjectIdResponse(id=1721874, encodeId=57281e2187412, content=<a href='/topic/show?id=01811016363e' target=_blank style='color:#2F92EE;'>#骨头#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101636, encryptionId=01811016363e, topicName=骨头)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9cd033099978, createdName=redcrab, createdTime=Tue Apr 25 03:42:18 CST 2023, time=2023-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1226905, encodeId=304212269056a, content=贫血吃红枣,补糖吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=25b01886537, createdName=ms1531565637822789, createdTime=Thu Jun 16 21:55:13 CST 2022, time=2022-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1234129, encodeId=c69712341294a, content=<a href='/topic/show?id=7e5081e99e9' target=_blank style='color:#2F92EE;'>#股骨头坏死#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81799, encryptionId=7e5081e99e9, topicName=股骨头坏死)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/Random/55971dc507c93968175ce7cc1e177b372a83869f.jpg, createdBy=f63e4754896, createdName=小小医者, createdTime=Sat Jul 23 03:18:22 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1226883, encodeId=66551226883fe, content=学习学习学习学习学习学习学习学习学习学习xxxx学习学习学习学习学习学习学习学习学习学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Thu Jun 16 20:36:22 CST 2022, time=2022-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1226867, encodeId=d315122686ed7, content=红枣不补血, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJKDuBScfXZlFlvJP0b5UGqZsEUM8n24VpERtNml2ziacd114VmerSEZ6u2ZPHCl8zeEcAX7H2w8UQ/132, createdBy=5b4f1970258, createdName=s海盗, createdTime=Thu Jun 16 19:15:42 CST 2022, time=2022-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1363035, encodeId=524c1363035e9, content=<a href='/topic/show?id=b723414321c' target=_blank style='color:#2F92EE;'>#坏死#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41432, encryptionId=b723414321c, topicName=坏死)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Wed Jun 15 10:42:18 CST 2022, time=2022-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1529759, encodeId=cde61529e597c, content=<a href='/topic/show?id=70ff81e9156' target=_blank style='color:#2F92EE;'>#股骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81791, encryptionId=70ff81e9156, topicName=股骨)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9d3011964327, createdName=wangyang7962, createdTime=Wed Jun 15 10:42:18 CST 2022, time=2022-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1584899, encodeId=fbf91584899ff, content=<a href='/topic/show?id=931581e97ad' target=_blank style='color:#2F92EE;'>#股骨头#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81797, encryptionId=931581e97ad, topicName=股骨头)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0ee217064831, createdName=huagfeg, createdTime=Wed Jun 15 10:42:18 CST 2022, time=2022-06-15, status=1, ipAttribution=)]
    2022-06-15 huagfeg

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