围绝经期妇女骨质疏松症153例临床观察

Clinical observation of 153 cases of peri-menopausal women with osteoporosis

目的观察围绝经期妇女不同时期骨密度的变化情况,为临床防治围绝经期骨质疏松症提供理论指导。方法选取153例围绝经期妇女为研究对象,按照绝经时间分为3组,绝经前期51例(A组),平均年龄(42.56±4.26)岁;绝经期48例(B组),绝经时间<1年,平均年龄(48.12±4.59)岁;绝经后期54例(C组),绝经时间>1年,平均年龄(52.23±4.33)岁,3组均采用双能X线骨密度仪测定受试者腰正位(L2~4)及左髋部(股骨颈)、大转子、华氏三角区部位的骨密度(BMD)情况;同时检测其血清雌二醇(E2)水平、骨代谢指标[包括I型羧基末端肽(CTX)、氨基酸中段骨钙素(NMID)、I型前胶原氨基端前肽(PINP)]的情况。结果 (1)C组较A组和B组各部位BMD显著降低(P<0.05);B组较A组腰L2~4、股骨颈部位的BMD显著降低(P<0.05);B组较A组大转子、华氏三角区部位的BMD值降低不明显(P>0.05)。(2)各组雌激素水平、骨代谢指标的情况表明,C组较A组和B组血清E2值呈显著下降趋势,NMID、CTX、PINP水平呈显著升高趋势;B组较A组血清E2值明显下降,NMID、CTX、PINP水平明显升高,差异均有统计学意义(P<0.05)。结论围绝经期妇女随绝经年龄增加,骨质疏松症明显上升,因此预防工作应尽早开始。

Objective To observe the change of bone density in peri-menopausal women in different periods and provide theoretical guidance for clinical prevention and treatment of postmenopausal osteoporosis.Methods Fifty-one menopausal women were divided into three groups according to menopause,51 patients（Group A）with an average age of（42.56±4.26）;48 menopause（Group B）,menopause time1 year,the average age of（48.12±4.59）;postmenopausal 54 cases（Group C）,menopause time 1 year,the average age of（52.23±4.33）.The bone mineral density（BMD）of the lumbar anteroposterior（2-4）and the left hip（femoral neck）,major rotator and Fahrenheit triangle were measured by dual energy Xray absorptiometry;While detecting the serum levels of estradiol（E2）and bone metabolic indices including type I carboxy terminal peptide（CTX）and amino acid in the middle before osteocalcin（NMID）,type I collagen amino terminal propeptide（PINP）.Results（1）Compared with group A and group B,BMD in group C decreased significantly（P〈0.05）;the BMD of L2-4 and femoral neck in group B was significantly lower than that in group A（P〈0.05）.The BMD of major rotator and Fahrenheit triangle in group B was not significantly lower than that in group A（P〈0.05）.（2）The estrogen levels,bone metabolism index in groups showed that serum E2 values were significantly lower and NMID,CTX,PINP levels was significantly increased in group C than that of group A and group B,（P〈0.05）;the serum E2 values were significantly lower and the levels of NMID,CTX and PINP were significantly higher in group B than that of group A,and the differences were statistically significant（P〈0.05）.Conclusion With menopause age increased,osteoporosis increased significantly for peri-menopausal women,so the prevention work should begin as soon as possible.