不同剂量雌激素联合孕激素对围绝经期综合征患者性激素及骨密度的影响

Effects of Different Doses of Estrogen Combined with Progesterone on Sex Hormones and Bone Mineral Density Inpatients with Perimenopausal Syndrome

目的 探讨不同剂量雌激素联合孕激素对围绝经期综合征患者性激素、骨密度的影响及不良反应的发生情况。方法 回顾性分析 2018 年 8 月-2020 年 8 月医院收治的 82 例围绝经期综合征患者,按照补充雌激素的用量分为低剂量组和高剂量组,每组 41 例。低剂量组采用 1mg 雌激素+10mg 孕激素治疗,高剂量组采用 2mg 雌激素+10mg 孕激素治疗,2 组患者均治疗 12 个周期(每个周期 28 天)。对比 2 组患者女性绝经期自测表(KI)评分,临床疗效,性激素水平,骨密度以及不良反应。统计学数据用 SPSS22.0 软件进行分析,计量资料以 t 检验,计数资料以 χ^(2)检验,P<0.05 为差异有统计学意义。结果 与治疗前相比,治疗后 2 组患者 KI 评分均降低(P<0.05),2 组间 KI 评分比较,差异无统计学意义(P>0.05);治疗后 2组总有效率比较,差异无统计学意义(P>0.05);与治疗前相比,治疗后 2 组血清卵泡刺激素(FSH)、黄体生成素(LH)水平均降低(P<0.05),2 组间血清 FSH、LH 水平比较,差异无统计学意义(P>0.05),与治疗前相比,治疗后 2 组血清雌二醇(E)水平均升高(P<0.05),且低剂量组血清 E水平低于高剂量组(P<0.05);与治疗前相比,治疗后 2 组腰椎 2~4、双侧髋关节密度均升高(P<0.05),2 组间腰椎 2~4、双侧髋关节骨密度比较,差异无统计学意义(P>0.05);低剂量组不良反应发生率低于高剂量组(P<0.05)。结论低剂量与高剂量雌激素联合孕激素用于围绝经期综合征患者均可改善临床症状,调节性激素水平,防止骨丢失,但应用低剂量雌激素安全性更好,不良反应发生率更低。

Objectives To explore the effects of different doses of estrogen combined with progesterone on sex hormones, bone mineral density and the incidence of adverse reactions in patients with perimenopausal syndrome.Methods Eighty-two patients with perimenopausal syndrome from August 2018 to August 2020 were divided into low-dose group and high-dose group, with 41 cases in each group. The low-dose group was treated with 1mg estrogen + 10mg progesterone, and the high-dose group was treated with 2mg estrogen + 10mg progesterone, two groups were treated for 12 cycles (28 d per cycle). The self-test table for women’s menopause (KI) scores, clinical efficacy, sex hormone levels, bone mineral density and adverse reactions of the two groups were compared. The statistical data were analyzed by SPSS22.0, measurement data was tested by t-test and enumeration data was tested bytest, P<0.05 was statistically significant. Results Compared with before treatment, the KI scores of the two groups were decreased after treatment (P<0.05), and there were no statistically significant difference in KI scores between the two groups (P>0.05). After treatment, there were no statistically significant difference in total effective rate between the two groups (P>0.05). Compared with before treatment, serum follicle stimulating hormone (FSH), luteinizing hormone (LH) levels in the two groups were decreased after treatment (P<0.05),there were no significant difference in serum FSH and LH levels between the two groups (P>0.05), compared with before treatment, the serum estradiol (E) level of the two groups were increased after treatment (P<0.05), and the serum Elevel of the low-dose group was lower than that of the high-dose group (P<0.05). Compared with before treatment, the bone mineral density of lumbar spine 2~4 and bilateral hip joint were increased in the two groups after treatment (P<0.05), there were no statistically significant difference in the bone mineral density of lumbar spine 2~4 and bilateral hip joint between the two groups (P>0.05). The incidence of adverse reactions in the low-dose group was lower than that in the high-dose group (P<0.05). Conclusions Low-dose and high-dose estrogen combined with progesterone could improve clinical symptoms, regulate sex hormone levels, and prevent bone loss in patients with perimenopausal syndrome, but low-dose was safer, and the incidence of adverse reactions was lower.