更年期综合征患者雌激素替代治疗对胰岛素样生长因子-1及骨密度的影响

Influence of estrogen-replacement therapy on insulin-like growth factor-1 and bone mineral density in patients with menopausal syndrome

目的探讨更年期综合征患者雌激素替代治疗前后血清IGF-1、骨密度变化。方法选取2014年6月~2016年6月我院收治的100例更年期综合征患者作为研究对象,依照就诊顺序将其随机分为研究组和对照组,每组各50例。对照组患者给予常规治疗,研究组患者在常规治疗基础上,口服戊酸雌二醇片/雌二醇环丙孕酮片,连续治疗6个月。比较两组患者的Kupperman评分、总有效率、血清雌二醇、胰岛素生长因子-1水平及胫骨、桡骨超声传播速度指标变化。结果治疗后,研究组患者的改良Kupperman评分低于对照组,差异有统计学意义(P<0.05);研究组患者治疗总显效率(94.0%)高于对照组(78.0%),差异有统计学意义(P<0.05);治疗后,研究组患者的血清E2、IGF-1水平均高于对照组,差异有统计学意义(P<0.05);治疗后,研究组患者的胫骨、桡骨超声传播速度高于治疗前,差异有统计学意义(P<0.05)。结论雌激素替代治疗可以增加患者雌激素水平,从而减轻更年期综合征患者的临床症状,还可增加血清胰岛素样生长因子-1水平,改善患者骨质疏松。

Objective To investigate the changes of serum insulin-like growth factor-1 （IGF-1） and bone mineral density （BMD） before and after estrogen-replacement therapy in patients with climacteric syndrome.Methods From June 2014 to June 2016,100 patients with menopausal syndrome admitted in our hospital were selected as objects and were randomly divided into research group and control group according to the order of visiting doctors,50 cases in each group.In the control group,routine treatment was used,while in the research group,on the basis of routine treatment,oral- administration of Estrdiolvlerte Tablet/Estradiol Progesterone Tablet for 6 continuous months.The Kupperman score,total effective rate,serum estradiol,insulin-like growth factor-1 （IGF-1） level,speed of ultrasound in tibia and radius were compared in research group and control group.Results After treatment,the improved Kupperman score of the research group was lower than the control group,and the difference was statistically significant （P〈0.05）.The total apparent efficiency （94.0%） was higher than the control group （78.0%）,and the difference was statistically significant （P〈0.05）.After treatment,the serum E2 and IGF-1 levels of the patients in the research group were higher than the control group,and the difference was statistically significant （P〈0.05）.After treatment,the spread of tibial and radial ultrasound in the re- search group were higher than before treatment,and the differences were statistically significant （P〈0.05）.Conclusion E-strogen-replacement therapy can increase the estrogen level,thereby alleviate the clinical symptoms of patients with menopausal syndrome,but also increase the level of serum IGF-1 and improve patient＇s osteoporosis.