两种激素补充治疗方案联合钙剂对绝经后妇女骨密度的影响

Comparative study on two different hormone replacement therapies combined with calcium in the bone mineral density of postmenopausal osteoporosis and osteopenia

目的 研究利维爱 1 2 5mg d和结合雌激素 (CEE) 0 6 2 5mg +安宫黄体酮 (MPA) 2mg联合钙剂对绝经后骨质疏松和低骨量妇女骨密度的影响。方法 绝经后妇女 30人 ,分为利维爱组和CEE组。利维爱组8例为骨质疏松 ,中位年龄 6 4岁 ,中位绝经年限 1 4年 ;9例为低骨量 ,中位年龄 5 2岁 ,中位绝经年限 3年 ,均给予利维爱 1 2 5mg d、Ca -D 6 0 0mg d口服。CEE组中位年龄为 5 1岁 ,中位绝经年限为 2 5年。治疗前及治疗 1年时用DEXA方法检查前臂远端骨密度各 1次 ,做为自身对照 ,对比骨密度变化情况同时每年通过阴道B超监测子宫内膜的厚度。结果 利维爱组骨质疏松患者 ,松质骨骨密度增长中位数为 +4 0 % ,密质骨为 +2 6 % ;低骨量者 ,用利维爱者分别为 0和 - 1 0 % ,用CEE者为 +0 3%和 - 0 7%。所有患者依从性好 ,无明显副作用发生。结论 利维爱 1 2 5mg

Objective To investigate the effect of two different hormone replacement therapies on postmenopausal osteoporosis and osteopenia Methods Among 30 cases,group A:8 osteoporosis (medium age 64 years old,medium postmenopausal period 14 years) and 9 osteopenia (52 years old,3 years postmenopausal) were treated with Livial 1 25 mg and Caltrate-D 600 mg daily Group B:11 osteopenia (51 years old,2 5 years postmenopausal) were given conjugated equine estrogen(CEE) 0 625 mg,Medroxyprogesterone (MPA) 2 mg and Caltrate-D 600 mg daily The following indicators were observed,① Bone mineral density (BMD) of forearm measured by duel energy X-ray absorptionmetry before and 12 months after treatment ② Endometrium thickness was measured yearly by transvaginal ultrasonography Results In group A,BMD of osteoporosis increased 4 0% in cancellous bone and 2 6% in compact bone,while no change and decreased 1% respectively in ospeopenia patients In group B,BMD increased 0 3% and decreased 0 7% respectively While no significant difference was found between groups Conclusions Livial 1 25 mg/d and Ca-D 600 mg/d can increase the forearm bone mineral density in postmenopausal osteoporosis