肌注醋酸甲羟孕酮避孕对25～40岁妇女骨矿物质密度的影响

The Effect of Depot Medroxyprogesterone Acetateon on the Bone Mineral Density in Women of Reproductive Age

目的:探讨肌肉注射避孕药醋酸甲羟孕酮(DMPA)对骨矿物质密度的影响。方法:随机选择68例应用DMPA避孕的25～40岁女性,每3个月肌注DMPA1次,用药24个月;同时选择59例25～40岁从未应用激素避孕药的女性做为对照,应用双能X光线吸收法测量腰椎和股骨颈骨矿物质密度(BMD)。结果:用药组用药2年后腰椎和股骨颈平均BMD从基础值1.106±0.110g/cm2和0.913±0.100g/cm2下降到1.045±0.103g/cm2和0.855±0.100g/cm2,分别下降了5.5%和5.9%,与对照组相比明显降低(P<0.01)。结论:25～40岁女性肌注醋酸甲羟孕酮避孕导致骨矿物质密度降低。

Objective： To probe into the the effect of intramuscular injection of depot medroxyprogesterone acetat （DMPA） on the bone mineral density （BMD）. Methods： 68 women aged between 25 and 40 years received intramuscular injection of DMPA every 3 months which continued for 24 months. 59 women aged between 25 and 40 years who never received nonhormonal contraception was as control group. BMD of the lumbar spine and femoral neck were measured with dual energy X - ray absorptiometry. Results： After 24 months of treatment , the mean BMD in lumbar spine and femoral neck were from baseline value of 1. 106 ± 0. 110g/cm^2 and 0. 913 ± 0. 100g/cm^2 to 1. 045 ± 0. 103g/cm^2 and 0. 855 ± 0. 100g/cm^2, and decreased 5.5% and 5.9%, respectively, which showed significant difference comparing with control group （ P 〈 0. 01 ）. Conclusion： Contraception with DMPA in women aged 25 to 40 years can lead to BMD declines.