长效避孕皮下埋植剂对生育妇女骨质的影响

The Effect of Long - released LNG Implant on Bone Density of Reproductive Women.

为探讨长期缓释单孕激素对妇女骨代谢的影响,测定使用国产Ⅰ、Ⅱ型长效避孕皮下埋植剂和Norplant 3年以上妇女的骨密度及骨代谢指标。采用回顾、设对照组的研究方法,测定123例妇女骨密度(BMD)及其骨代谢指标血钙(Ca)、磷(P)、碱性磷酸酶(ALP)、骨钙素(BGP)、血清雌激素(E_2),尿钙(Ca)、尿肌肝(Cr)和尿羟脯氨酸(HYP)等。结果表明国产Ⅰ、Ⅱ型和Norplant组妇女骨峰值形成期(30～40岁)使用皮埋剂的三组妇女平均E_2水平有不同程度降低,但均在正常低限水平内,与对照组间无差别。除对照组外三组妇女平均E_2水平与BMD之间不呈线性关系;Norplant组妇女BMD和Ca/Cr、HTP/Cr的变化说明骨吸收过程增强。使用国产Ⅰ、Ⅱ型皮埋剂和Norplant妇女3年后平均E_2水平在正常低水平上波动,未造成BMD的变化及其它骨代谢指标的明显变化;三组皮埋剂妇女骨峰值形成期(30～40岁),骨密度处于正常水平范围。长效LNG缓释皮埋剂对育龄妇女在骨代谢方面是安全的。

The purpose of this paper was to study the effect of long- releasing levonorgestrel (LNG) implant only on the bone metabolism of reproductive women by means of determining the bone density (BMD) and indicators of bone metabolisim in domestic Implant type Ⅰ type Ⅱ and Norplant users for three years over. Data were from a retrospective study among 123 women and controls matched by age. Results revealed that the mean levels of estrogen (E2) decreased at different digrees in women who used Implant typeⅠ , type Ⅱ and Norplant. The E2 was at the lower range of normal level. There was no significant difference compared with the control group during the bone peak formation period(30 - 40 years - old). There were no line - relationship between the mean E2 level and BMD in three groups except the control. The changes of BMD,Ca/Cr and Hyp/Cr of Norplant users showed that the bone absorption was slightly stregthen. Conclusion: The mean K2 levels of Implant type Ⅰ , Ⅱ and Norplant users for 3 years over were fluctuated at the lower range of normal level, and there was no significant effect on BMD and other indicators of bone metabolism of women; BMD in three groups was at normal levels during the period (30 - 40 years old) of bone peak formation. Long - released LNG implant is safe on bone metabolism in reproductive women.