摘要
目的评价雷洛昔芬对长期应用促性腺激素释放激素类似物(gonadotropin-releasing hormone analogues,GnRH-a)治疗子宫内膜异位症引起的骨质丢失的影响。方法选择38例中重度子宫内膜异位症术后患者,给予亮丙瑞林(3.75 mg/4周)+雷洛昔芬(60 mg/d),治疗持续48周,治疗前后检测骨密度(bone mineral density,BMD)、血清骨钙素、碱性磷酸酶、尿吡啶啉/肌酐水平。结果与治疗前比较,治疗48周后患者腰椎2-4的BMD[(1.193±0.079)vs.(1.187±0.069)g/m2]和股骨颈BMD[(0.908±0.074)vs.(0.896±0.084)g/m2]轻度下降,血清骨钙素[13.42(9.45,18.96)vs.13.46(10.41,17.41)ng/m L]、碱性磷酸酶[79.61(56.24,109.47)vs.91.27(66.34,110.50)U/L]、尿吡啶啉/肌酐[22.31(20.63,23.66)vs.22.77(20.93,26.13)nmol/mmol]轻度升高,但治疗前后差异均无统计学意义(P>0.05)。结论雷洛昔芬联合GnRH-a可延长中重度子宫内膜异位症的疗程,并不增加骨质疏松的风险。
Objective To evaluate the efficacy of raloxifene in preventing bone loss induced by long term gonadotropin-releasing hormone analogues（GnRH-a） administration. Methods Thirty-eight women with severe endometriosis were treated with leuprolide acetate depot at a dosage of 3.75 mg/4 weeks and raloxifene 60 mg/d, for 48 weeks after the operations. Bone mineral density （BMD）, serum osteocalcin, alkaline phosphatase, and urinary pyridinoline/creatinine were measured at admission, and after treatment. Results After 48 weeks of GnRH-a plus raloxifene, L2-4 and femoral neck s BMD decreased slightly, respectively [（1.193±0.079） vs. （1.187±0.069）g/m 2], and [（0.908±0.074） vs. （0.896±0.084）g/m 2]. Serum osteocalcin, alkaline phosphatase, and urinary pyridinoline/creatinine increased slightly, respectively [13.42（9.45, 18.96） vs. 13.46（10.41, 17.41）ng/mL], [79.61（56.24, 109.47） vs. 91.27（66.34, 110.50）U/L], and [22.31（20.63, 23.66） vs. 22.77（20.93, 26.13）nmol/mmol]. All differences were not significant （all P 〉0.05）. Conclusion Our study shows that the administration of GnRH-a plus raloxifene in women with severe endometriosis is an effective long-term treatment and does not increase the risk of osteoporosis.
作者
张颖
王慧彪
赵倩
胡珍华
ZHANG Ying;WANG Hui-biao;ZHAO Qian;HU Zhen-hua(Department of Gynaecology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Osteoporosis,Luoyang Orthopedic Hospital,Orthopedics Hospital of Henan Province,Luoyang 471002,China)
出处
《中华骨质疏松和骨矿盐疾病杂志》
CSCD
北大核心
2018年第4期365-368,共4页
Chinese Journal Of Osteoporosis And Bone Mineral Research
