应用小剂量激素防治围绝经期妇女骨质疏松症.docVIP

应用小剂量激素防治围绝经期妇女骨质疏松症[摘要] 目的：观察小剂量激素应用在防治围绝经期骨质疏松症方面的疗效，探讨其临床应用价值。方法：将90例围绝经期妇女/绝经后妇女随机分为3组，给予钙剂和维生素D口服基础上，A组（n=30）给予口服雌激素（CEE）+醋酸甲羟孕酮（MPA），B组（n=30）给予戊酸雌二醇（E2V）+MPA，C组（n=30）不给予任何雌激素；治疗前、治疗1年后测量腰椎（L1~4）后前位骨密度、左侧股骨上端（股骨颈、大转子、沃氏三角区）骨密度；治疗期间每3个月复查1次，记录不良反应。结果：①治疗1年后，C组患者腰椎骨L1~4、股骨颈、沃氏三角区骨密度明显低于治疗前，低于A组与B组治疗后骨密度（P0.05）；②用药3个月时，A组出血率高于B组和C组，B组高于C组，差异均有统计学意义（P0.05）。结论：小剂量激素应用可以有效防治围绝经期、绝经后妇女的骨质疏松症，延缓骨质丢失的疗效明确 [关键词] 围绝经期；骨质疏松症；小剂量激素；防治效果 [中图分类号] R58 [文献标识码] B [文章编号] 1674-4721（2011）11（c）-061-02 Clinical effects of small dose estrogen on prevention and treatment of postmenopausal osteoporosis LIU Changyun Department of Gynaecology and Obstetrics, the People’s Hospital of Yingcheng City, Hubei Province, Yingcheng 432400, China [Abstract] Objective: To evaluate the clinical effects of small dose estrogen on prevention and treatment of postmenopausal osteoporosis. Methods: 90 peri- and post-menopausal women were randomly divided into 3 groups. All subjects were given calcium carbonate and vitamin D. Group A (n=30) took conjugated estrogen + medroxyprogesterone acetate (MPA). Group B (n=30) took estradiol valerate + MPA. The bone mineral density of lumbar verteba and hip bone was measured before the drug administration and one year after the study. Results: There was statistically significant difference between the post-anterior bone mineral denisty of the bosworth (L1-4) of group C (P0.05). Conclusion: Small dose of estrogen has good clinical effect in preventing osteoporosis in menopause. [Key words] Perimenopause; Osteoporosis; Small dose estrogen; Prevention and treatment effects 围绝经期指的是妇女绝经前、后的一段时期内（40岁左右至停经后1年内的时期），妇女这一特殊的生理变化过程会经历骨质渐进性丢失，当骨量减少至某一个程度时即为骨质疏松症，围绝经期妇女约25%患骨质疏松症[1]。目前处理妇女围绝经期骨质疏松症更着重于预防，雌激素在胃肠道内能够促进维生素D的合成钙吸收。本文观察小剂量激素应用对围绝经期妇女骨质疏松症的防治效果，现报道如下: 1 资料与方法 1.1 一般资料 2008年2月~2011年2月于本院门诊就诊的90例围绝经期和绝经后妇女，年龄40~65岁，平均48.5岁。排除高血压、糖尿病、心脏病变、激素依赖的恶性肿瘤、血栓性疾病、雌激素禁忌证、妇科器质性病变、肝肾功能异常或其他影响骨代谢的疾病。所有患者无激素用药史，随机分为A组（n=30）、B组（n=30）和C组（n=30），对比3组患者的一般情况，