妊娠期及哺乳期妇女跟骨骨密度的超声定量监测

ULTRASOUND BONE MINERAL DENSITY IN PREGNANCY AND LACTATION

目的超声定量监测妊娠期及哺乳期妇女跟骨骨密度,研究妊娠及哺乳期妇女骨密度的变化规律,探讨超声监测的意义.方法采用MARCURY超声骨密度仪对41名孕16～20周,35名孕30～33周及36名产后40～60天(哺乳期)的健康妇女进行跟骨骨密度测定.结果孕16～20周,孕30～33周及产后40～60天妇女跟骨骨密度(BMD-H)依次降低为0.526±0.116g/cm2,0.503±0.083g/cm2,0.459±0.054g/cm2.超声传导速度(SOS)分别下降至1837±120.3m/s,1835±133.4m/s,1768±77.82m/s.BMD,SOS于孕30～33周出现降低,但较孕16～20周无统计学差异.产后40～60天哺乳期妇女跟骨BMD,SOS明显下降,较孕16～20周,孕30～33周妇女具有显著性差异(P<0.01).结论①骨量丢失贯穿于整个孕,产及哺乳期,骨密度的下降于孕后期及哺乳期达到统计学意义,故骨密度监测可始于孕后期(>33周).②超声骨密度测定因安全有效简便,作为妊娠期及哺乳期妇女骨密度定量监测,具有其独特的临床应用价值.

Objectives The aim of this study is to exam the change of the bone mineral density in pregnancy and lactation using ultrasound technology. Materials BMD of heel bone （ BMD-H ） and speed of sound （SOS） were measured by MARCURY ultrasound bone densitometry device in 41 women （pregnant between 16～20 weeks） ; 35 women （pregnant between 30- 33weeks） ; 36 women （40 -60days postpartum ＆ lactation）. Results BMD-H in postpartum group were reduced to 0.459 ＋ 0. 054 g/cm2 compared with the first group （pregnant between 16～20weeks） 0.526 ± 0.116 g/cm^2, and the second group （pregnant between 30～33weeks） 0. 503±0. 083g/cm^2. SOS also decreased to 1768 ±77.82 m/s in postpartum group while the first and second group were 1837± 120.3 m/s and 1835 ±133.4 m/s. Different to other reports we found these decrease of BMD-H, SOS between 16～20weeks and 30～33weeks were no statistical significance （P 〉0.01 ） , while these decrease between postpartum and two groups of pregnancy were all obviously statistical significant（ P 〈 0.01 ）. Conclusion A reduction of ultrasound bone density was observed throughout pregnancy, especially in the period of later stage of pregnancy, delivery and lactation when the greatest calcium transfer from mother to fetus. The loss of bone was not significant in early and middle stage in pregnancy, so we could monitor it after pregnant 33 weeks. Ultrasound bone densitometry a radiation-free technology is more safe, economy and convenient in obstetrics than DEXA, SPA and QCT, so it has a special clinical value and could be used in different hospitals.