产后早期妇女骨质疏松相关因素分析

Analysis of the factors related to osteoporosis in early postpartum women

目的了解产后早期妇女骨量丢失的影响因素,为防止妊娠有关的骨质疏松发生提供依据。方法纳入在我院分娩的产后10～14天妇女1125例,采用双能X线骨密度测定仪测定受试者L1-L4椎体及左侧股骨颈的骨密度(BMD),根据骨密度分为骨质疏松组、骨量减少组、骨量正常组,比较各组间年龄、身高、体重指数(BMI)、产次、钙摄入量等差异。结果在1125例调查者中,骨质疏松65例(5.8%),骨量减少429例(38.1%),骨量正常631例(56.1%)。牛奶摄入量每天>200 ml的产妇,其骨质疏松发生率低于牛奶每天摄入<200 ml的产妇(P<0.01)。孕期补钙的产妇骨质疏松发生率低于未补钙者(P<0.01),有骨质疏松家庭史的产妇,其骨质疏松发生率高于无骨质疏松家庭的产妇(P<0.01)。结论产后妇女骨质疏松及骨量减少的发生率较高,骨质疏松家族史、钙摄入不足、低BMI是产后骨量丢失的风险因素,产后常规测量骨密度有助于骨质疏松的早期诊断及治疗。

Objective To analyze the factors related to osteoporosis in early postpartum women, and to provide basis for the prevention of pregnancy-related osteoporosis. Methods A total of 1125 women, who delivered in our hospital, were involved in this study 10-14 days after their parturition. The bone mineral density （BMD） of the lumbar vertebrae and the left femoral neck was detected using dual energy X-ray absorptiometry. All the subjects were divided into osteoporosis group, osteopenia group, and normal bone mass group according to BMD. The variation of age, body height, body mass index （BMI） , parity, and the quantity of calcium intake were compared among groups. Results In all these 1125 subjects, 65 women （5.8%） were diagnosed osteoporosis, 429 （38. 1% ） osteopenia, and 631 women （56.1% ） had normal bone mass. The incidence of osteoporosis in women intaking more than 200ml/d milk was lower than that in women intaking less than 200ml/d milk （ P 〈 0.01 ）. The incidence of osteoporosis in women with calcium supplementation during pregnancy was lower than that in women without calcium supplementation （ P 〈 0.01 ）. And the incidence of osteoporosis in women with family history of osteoporosis was higher than that in women without family history of osteoporosis （P 〈 0.01 ）. Conclusion The incidence of osteoporosis and osteopenia is high in postpartum women. The family history of osteoporosis, insufficient calcium intake, and low BMI are main risk factors of bone mass loss in postpartum women. Routine measurement of BMD in postpartum women is useful for the early diagnosis and treatment of osteoporosis.