妊娠妇女骨骼密度变化的观察

Study of Bone Mineral Density in Pregnant Women

目的观察妊娠期到产后妇女骨骼密度的变化。 方法 198名妇女 ,分为四组 ,妊娠 2 4周 6 3人、36周 5 3人、产后 6周 5 8人及对照组 2 4人 ,运用英国CUBAClinical定量骨超声分析系统 ,测定其左侧跟骨的骨密度 [宽频超声衰减 (BUA)和超声传导速度 (VOS) ],分析妊娠对骨密度的影响。 结果四组妇女的BUA没有明显差异 ,VOS随妊娠发展直到产后逐渐下降 ,与对照组相比 ,妊娠 2 4周及 36周VOS虽渐有下降 ,但并无显著性差异 ,产后 6周组妇女VOS值较妊娠组及对照组明显下降 (P <0 .0 5 )。 结论妊娠期间存在骨密度下降现象 ,但到产后 6周才能检测到定量骨超声指标的变化。定量骨超声作为一种无福射、无创伤的骨骼强度测定技术 ,适用于妊娠妇女骨骼强度监测。

Objective To find out the changing pattern of bone mineral density in women from pregnancy to postpartum. Methods 116 pregnant women (63 women at 24 weeks of pregnancy and 53 at 36 weeks) and 58 postpartum women were measured for broadband ultrasound attenuation (BUA) and velocity of sound (VOS) at their left calcaneum with a CUBA Clinical ultrasonic bone densitometry system. The relation between pregnancy and ultrasonic measurements were analyzed. 24 non pregnant women served as control group. Results Among the 4 groups, no difference were in BUA, but VOS decreased from control group to postpartum group. Compared with the control group (VOS=1655m/s), VOS decreased in the 2 pregnant groups (1653m/s and 1649m/s, respectively) but without difference(P>0.05). In postpartum group (1631m/s), VOS decreased significantly compared with the other 3 groups (P<0.05). Conclusion During pregnancy, bone mineral density decreased too slowly to be detected, and the changes of quantitative ultrasonic parameters could be detected until 6 weeks postpartum. As a technique without radioactivity and noninvasive, quantitative ultrasonic densitometry is suitable in bone density measurement for pregnant women.