摘要
目的探讨低剂量性激素治疗方案对绝经后妇女骨量丢失的影响。方法将2002年3月至2003年3月诊治的90例绝经妇女随机分为3组，A组（31例）：每日服用戊酸雌二醇1mg＋醋酸甲羟孕酮2mg；B组（29例）：每日服用结合雌激素0．45mg＋醋酸甲羟孕酮2mg；C组（30例）：每日服用7-甲异炔诺酮1．25mg，共服药12个月。各组均每日服用元素钙400mg。治疗前后分别测定第2～4腰椎骨（L2-4）骨密度、骨代谢生化指标尿N端交联多肽／肌酐（NTX／Cr）值及血清总碱性磷酸酶（ALP）水平。结果治疗12个月时B组L2-4骨密度上升显著（上升0．039g／cm^2，P〈0．01），A与C组骨密度变化不明显（均P〉0．05）；治疗后L2-4。骨密度B组与A组、C组比较差异均有统计学意义（均P〈0．05），A组和C组之间差异无统计学意义（P〉0．05）。治疗6个月3组尿NTX／Cr值均下降，其巾B组、C组下降明显（均P〈0．05），组间比较差异均无统计学意义（P〉0．05）。治疗12个月时各组血ALP水平均明显下降（P〈0．01）．下降程度相似（P〉0．05）。结论3种低于标准剂量的性激素治疗12个月均可对抗绝经后妇女骨量丢失。
Objective To determine the effects of sexual hormone therapy at varied doses on prevention of bone mineral loss in Chinese postmenopausal women. Methods From March 2002 to March 2003, 90 Chinese postmenopausal women were randomly divided into three groups, each given one of the following regiments for 12 months, estradiol valerate （EV） 1 mg plus medroxyprogesterone （MPA） 2 mg for group A （31 subjects）, conjugated estradiol （ ethinylestradiol-3-cyclopentylether, CEE） 0.45 mg plus MPA 2 mg for group B （29 subjects） and livial 1.25 mg for group C （30 subjects）, respectively. In addition, 400 mg of elemental calcium were given daily to all those women. Bone mineral density （BMD） of the 2rid to 4th lumbar vertebra （ L2-4 ） and biochemical markers of bone turnover, urine N-telopeptide of type Ⅰ collagen/creatinine（NTX/Cr） and serum total alkaline phosphatase （ALP） , were measured before and after drug administration. Results After treatment for 12 months, BMD of the L2-4 increased significantly by 0. 039 g/cm^2 （P 〈 0.01 ） in group B, but not significantly in group A or group C （P〈 0.05 ）. Increases in BMD of the L2-4 was more in group B than that in group A and group C, respectively （P 〈 0.05）, but no significant difference in BMD increase between group A and group C was found （P 〉 0.05）. After treatment for 6 months, urine NTX/Cr reduced from the baseline for all the three groups （P 〈 0.05）, but no significant difference among group A, group B and group C was found （ P 〉 0.05 ）. After treatment for 12 months, serum ALP significantly reduced from the baseline for all the three groups （P 〈 0.01 ）, but no significant difference among group A, group B and group C was found （ P 〉 0.05 ）. Conclusions Sexual hormone therapy at varied doses lower than regular one for 12 months was effective in preventing bone mineral loss in postmenopansal women.
出处
《中华全科医师杂志》
2008年第11期758-761,共4页
Chinese Journal of General Practitioners
关键词
激素替代疗法
骨密度
骨质疏松
绝经后
Hormone replacement therapy
Bone density
Osteoporosis, postmenopausal
