卵巢切除对绝经前妇女骨代谢的影响

Clinical study on effect of ovariectomy on bone metabolism of women in premenopause

目的:观察卵巢切除对绝经前妇女骨代谢的影响。方法:检测绝经前因各种原因行卵巢切除术的74例患者的血清骨碱性磷酸酶及血清抗酒石酸酸性磷酸酶5b,其中单侧卵巢切除者48例(A组),双侧卵巢切除者26例(B组),并与未停经且无卵巢手术史的30例健康妇女(C组)作对照。结果:3组间BALP水平的差异具有统计学意义(F=10.08,P=0.0032);A组患者的BALP水平高于B组(q=4.12,P=0.0073),而低于C组(q=2.97,P=0.038),B组患者的BALP水平低于C组(q=6.34,P=0.0030)。3组间TRACP5b水平的差异具有统计学意义(F=13.79,P=0.0001);A组患者的TRACP5b水平低于B组(q=4.20,P=0.0072),而高于C组(q=4.15,P=0.0073),B组患者的TRACP5b水平高于C组(q=7.51,P=0.0024)。结论:绝经前因各种疾病行卵巢切除后,成骨细胞活性降低,骨形成减少;破骨细胞活性增强,骨吸收加快。应在术后早期检测骨代谢生化指标,为防治骨质疏松症提供依据。

Objective：To observe the effect of ovariectomy on bone metabolism of women in premenopause. Methods：74 patients who were oophoreetomized for various diseases before menopause were chosen to be studied. Among these patients ,48 cases who were unilateral oophorectomized were divided into group A and 26 cases who were bilateral oophorectomized were divided into group B. At the same time, 30 normal women were chosen for control. Serum levels of bone alkaline phosphatase（BALP） and tartrate - resistant acid phosphatase 5b （TRACP5b） in all these women were detected. Results：There were statistical differences of the serum levels of BALP among the three groups （F = 10.08,P = 0. 003 2 ）. The serum levels of BALP in group A were higher than those in group B （q = 4.12, P = 0.007 3 ） and were lower than those in group C（q =2.97, P =0.038） ,while the serum levels of BALP in group B were lower than those in group C（q = 6.34, P = 0. 003 0 ）. There were statistical differences of the serum levels of TRACP5 b among the three groups （ F = 13.79, P = 0.000 1 ）. The serum levels of TRACP5b in group A were lower than those in group B（q =4.20, P =0.007 2） and were higher than those in group C（q =4.15, P =0. 007 3） ,while the serum levels of TRACP5b in group B were higher than those in group C（q =7.51, P =0. 002 4）. Conclusion： Ovariectomy before menopause leads to a decrease in the activity of osteoblast and an increase in the activity of osteoelast. As a result, the bone formation decreases and the bone resorption increases. Therefore, the biochemical parameters of bone metabolism should be detected early after ovariectomy in order to provide proof to prevent osteoporosis.