尼尔雌醇防治绝经后及老年妇女骨质疏松的临床观察

Effect of nilestriol on prevention of osteoporosis in postmenopausal and elderly women

对 2 0例绝经后妇女和老年妇女分别给予尼尔雌醇用药 3个月 ,并于给药前后分别测定空腹尿钙与肌酐 (Ca/Cr) ,羟脯氨酸与肌酐 (OHPr/Cr)比值以及血清碱性磷酸酶 (AKP)、雌二醇 (E2 )、降钙素 (CT)的值。以探讨尼尔雌醇减缓不同绝经年限妇女骨量丢失的作用机制。结果显示尼尔雌醇给药前后两组妇女血清E2 的水平未见明显变化 ,但其血清CT的水平均较给药前有程度不同的升高。空腹尿Ca/Cr、OHPr/Cr比值以及血清AKP水平均较给药前显著下降 (P <0 0 0 5及P <0 0 1)。故此提示 ,尼尔雌醇可能通过刺激甲状腺C细胞而增加CT的分泌或直接作用于骨组织等多种途径抑制骨质的吸收 ,维持其骨矿含量的相对稳定。因此 ,本研究在国内首次为尼尔雌醇用于减缓老年妇女骨质的丢失提供了一定的理论依据。

In order to study the effect of nilestriol on prevention of osteoporosis in elderly women 20 postmenopausal women and elderly women were randomly divided into two groups and were treated separately with nilestriol for two months. Then fasting urinary calcium creatinine ratio (Ca/Cr) and hydroxyprolin creatinine ratio (OHPr/Cr), serum estradiol (E2), calcitonin (CT) and alkaline phosphatase (AKP) were determined before and after treatment. The results showed that serum E2 values were not significantly altered. But Ca/Cr, OHPr/Cr and AKP values were lowered after treatment in the two groups of women. It is probable that nilestriol improves bone metabolism by increasing the serum level of CT, or acts on bone directly. It is concluded that the administration of nilestriol is of clinical significance for prevention of osteoporosis in elderly women.