雌二醇屈螺酮片对绝经期女性骨密度和骨代谢影响64例临床观察

Estradiol and drospirenone tablets can improve the bone mineral density and bone turnover markers: a prospective,self-controlled study

目的探讨激素补充治疗药物雌二醇屈螺酮片对绝经期女性骨密度和骨代谢的影响, 方法选取2012 年3 月-2013 年6 月在海军总医院就诊并采用雌二醇屈螺酮片治疗绝经期症状的45-60（52. 5±3. 4）岁女性,并于治疗3 个月及6 个月时进行随访,对治疗前后患者的骨密度和骨代谢指标进行观察, 结果共64例入组并完成随访, 治疗后患者绝经症状较治疗前明显缓解, 治疗6 个月后腰椎及髋部大粗隆的骨密度较治疗前明显升高[治疗6 个月时分别为（1. 025 0±0. 019 1） g/ cm^2、（0. 484 7±0. 138 0） g/ cm^2,治疗前分别为（1. 016 7±0. 104 6） g/ cm^2、（0. 455 5±0. 089 9） g/ cm2],差异均有统计学意义（P〈0. 05）, 治疗后骨代谢标志物骨碱性磷酸酶和抗酒石酸酸性磷酸酶较治疗前明显下降[治疗前分别为（65. 82±14. 75） U/ L 和（6. 15±3. 02） U/ L,治疗3 个月时分别为（61. 14±12. 38） U/ L 和（5. 99±2. 98） U/ L,治疗6 个月时分别为（58. 77±11. 35） U/ L 和（4. 90±2. 90） U/ L],差异均有统计学意义（P〈0. 05）, 结论雌二醇屈螺酮片能有效缓解绝经后女性的骨密度和骨代谢指标,有助于绝经后女性骨质疏松性骨折的预防.

Objective To investigate the effects of estradiol and drospirenone tablets( E2 /DRSP) on bone mineral density and bone turnover markers. Methods This was a prospective,self-controlled cohort study. Postmenopausal women who were treated with E2 / DRSP for at least 6months from March 2012 to June 2013 and at the age of 45 — 60( 52. 5±3. 4) years were enrolled.Comparisons were made by bone mineral density and bone turnover markers( bone alkaline phosphatase and tartrate-resistant acid phosphatase) between pre-and post-treatment. Results A total of 64 women were enrolled. Symptoms of menopausal syndrome alleviated significantly. Bone mineral densities of the lumber spine [( 1. 016 7±0. 104 6) g / cm2vs( 1. 025 0±0. 019 1) g / cm2]and the hip[( 0. 455 5±0. 089 9) g /cm2vs( 0. 484 7 ± 0. 138 0) g / cm2] were significantly improved after 6months of treatment( P < 0. 05). Levels of bone alkaline phosphatase [( 65. 82 ± 14. 75) U / L at baseline vs( 61. 14±12. 38) U / L,( 58. 77 ± 11. 35) U / L at 3rd and 6th month,respectively,P <0. 05]and tartrate-resistant acid phosphatase [( 6. 15±3. 02) U / L at baseline vs( 5. 99±2. 98) U /L,( 4. 90±2. 90) U / L at 3rd and 6th month,respectively,P<0. 05) ]were significantly decreased after treatment of E2 / DRSP. Conclusion E2 / DRSP can alleviate symptoms of menopausal syndrome effectively,and also has benefits for bone mineral density and bone metabolism.