绝经前子宫切除对卵巢功能及骨代谢和骨密度的影响

Effects of premenopausal hysterectomy with conservation of one or two ovaries on bone metabolism and bone density

目的 研究子宫全切而保留卵巢患者远期卵巢激素水平及骨代谢、骨密度情况。方法子宫全切保留单侧卵巢者48例,保留双侧卵巢者15例及对照组30例。所有观察对象均测定血清E2、FSH及血清Ca、血P、血AKP、血BGP、及空腹尿Ca/Cr及尿HYP/Cr值、骨密度值。结果 单侧卵巢保留组血AKP值显著高于对照组(P<0.05),血BGP显著高于对照组(P<0.01),且空腹尿Ca/Cr及尿HYP/Cr值均显著高于对照组(P<0.01),骨密度值显著低于对照组(P<0.05)。双侧卵巢保留组尿HYP/Cr值显著高于对照组(P<0.05)。结论 子宫全切保留单侧卵巢者远期易发生骨量丢失致骨密度下降,双侧卵巢保留者亦有骨吸收加快,但无骨密度下降。

Objective To investigate the bone metabolism and bone density of women who had pre-menopausal hysterectomy with conservation of one or two ovaries. Methods Forty eight women with one ovary conserved and 15 women with two ovaries conserved were recruited to this study. There were 30 women with regular menstruation as control group who were randomly selected. All women were examined for serum E2, FSH, Ca, P, AKP, BGP, urin Ca/Cr, Urine HYP/Cr, and bone mineral density. Results The AKP and BGP levels in women with one ovary conserved were significantly higher than these in the control group (P < 0.05, P < 0.01), Urine Ca/Cr and urine HYP/Cr were also significantly higher than those in the control group (P < 0.01) ,and the bone density was significantly lower than that in the control group ( P < 0.05) . The Urine HYP/Cr in women with two ovaries conserved was significantly higher than that in the control group ( P < 0.05) . Conclusions It is suggested that the hysterectomized women with one or two ovaries conserved will meet the problem of increased bone turnover and bone loss and lower bone desity. Although the women with two ovaries conserved also have increased bone ab-sorption, lower bone density is not found in the study.