应用小剂量激素防治围绝经期妇女骨质疏松症

Clinical effects of small dose estrogen on prevention and treatment of postmenopausal osteoporosis

目的：观察小剂量激素应用在防治围绝经期骨质疏松症方面的疗效,探讨其临床应用价值。方法：将90例围绝经期妇女/绝经后妇女随机分为3组,给予钙剂和维生素D口服基础上,A组（n=30）给予口服雌激素（CEE）＋醋酸甲羟孕酮（MPA）,B组（n=30）给予戊酸雌二醇（E2V）＋MPA,C组（n=30）不给予任何雌激素;治疗前、治疗1年后测量腰椎（L1~4）后前位骨密度、左侧股骨上端（股骨颈、大转子、沃氏三角区）骨密度;治疗期间每3个月复查1次,记录不良反应。结果：①治疗1年后,C组患者腰椎骨L1~4、股骨颈、沃氏三角区骨密度明显低于治疗前,低于A组与B组治疗后骨密度（P〈0.05）;3组患者治疗前、后的子宫内膜厚度无明显改变（P〉0.05）;②用药3个月时,A组出血率高于B组和C组,B组高于C组,差异均有统计学意义（P〈0.05）;用药6个月,A组出血率高于B组和C组（P〈0.05）;用药9个月及12个月,3组的出血率差异均无统计学意义（P〉0.05）。结论：小剂量激素应用可以有效防治围绝经期、绝经后妇女的骨质疏松症,延缓骨质丢失的疗效明确。

Objective： To evaluate the clinical effects of small dose estrogen on prevention and treatment of postmenopausal osteoporosis. Methods： 90 periand post-menopausal women were randomly divided into 3 groups. All subjects were given calcium carbonate and vitamin D. Group A （n=30） took conjugated estrogen ＋ medroxyprogesterone acetate （MPA）. Group B （n=30） took estradiol valerate ＋ MPA. The bone mineral density of lumbar verteba and hip bone was measured before the drug administration and one year after the study. Results： There was statistically significant difference between the post-anterior bone mineral denisty of the bosworth （L 1-4 ） of group C （P0.05）. The rate of colporrhagia in group A was much higher than group B and group C （P0.05） in 3 months and 6 months after the study. There was no significant difference among group A, group B and group C of colporrhagia in 9 months and 12 months after the study （ P0.05）. Conclusion： Small dose of estrogen has good clinical effect in preventing osteoporosis in menopause.