不同方案联合用药治疗围绝经期骨质疏松症的疗效观察

EFFECT OF PREMARIN AND MEDROXYPROGESTERONE ACETATE(MPA) ON PATIENTS WITH OSTEOPOROSIS OF PEIRMENOPAUSAL PERIOD

目的观察安宫黄体酮与天然结合雌激素(倍美力)联合氨基酸钙治疗围绝经期骨质疏松(OP)的疗效。方法将46例围绝经期骨质疏松患者随机分为观察组与对照组,后者以氨基酸钙+安宫黄体酮治疗,观察组加用黄体酮治疗,观察组在对照组的基础上加用倍力美进行序贯治疗。疗程为6个月,比较治疗前后骨密度、内分泌代谢指标的变化以及不良反应的发生率。结果治疗前两组患者的骨密度(BMD)、雌二醇(E2)、黄体生成素(LH)、碱性磷酸酶(ALP)及尿钙/肌酐(UCa/Cr)比值均无统计学差异;治疗后,二组BMD、ALP、UCa/Cr等指标均较治疗前明显改善(p<0.05),观察组骨密度高于对照组(p<0.05),且ALP及尿钙/肌酐比值均低于对照组(p<0.05)。治疗OP总体临床疗效比较显示观察组的疗效等级优于对照组,子宫内膜和乳腺体层厚度的变化、阴道出血及胀乳上的差异无统计学意义(p>0.05)。结论两种方案均能有效治疗围绝经期骨质疏松,倍美力加安宫黄体酮组较安宫黄体酮组能更好的改善骨密度及骨代谢相关指标,因此更加适合于治疗围绝经期骨质疏松症。

Objective To observe the effect of premarin and medroxyprogesterone acetate（MPA） on patients with osteoporosis of peirmenopausal period. Methods 46 subjects were randomly divided into the test and control group（both n=23）.The control group were given amino acid calcium tablet,as well as MPA,for 6 months.Based on this,patients in the test group were sequentially administrated with premarin.The bone mineral density（BMD） and the other indexes related to bone metabolism were detected before and after treatment.Moreover,the adverse reactions were also observed. Results There was no difference in BMD,estradiol（E2）,luteinizing hormone（LH）,alkaline phosphatase（ALP） and urine calcium/creatinine（UCa/Cr） between the two groups.The above-mentioned 5 indexes were all significantly improved after treatment（p0.05） for both groups.But compared with the control group,BMD in the test group was significantly higher,and the ALP and UCa/Cr were lower（both p0.05）.For the clinical outcome and adverse reaction ratios,there was no difference between the two groups after treatment either. Conclusion Compared with MPA,premarin could better improve bone metabolism and thus treat patients with osteoporosis of peirmenopausal period more effectively.