绝经后女性预防性卵巢切除术对性激素水平及骨密度的影响

Effect of prophylactic oophorectomy on sex hormone level and bone mineral density in postmenopausal women

目的探讨绝经后女性预防性卵巢切除对性激素水平及骨密度的影响。方法选取2019年1月~2021年1月在绵阳市中心医院就诊因子宫良性疾病需行全子宫切除术并选择预防性切除双侧输卵管卵巢的绝经后妇女58例,在术前、术后1月、术后6月、术后1年测定腰椎骨密度(BMD)以及血清性激素水平,包括雌二醇(E2)、睾酮(T)、卵泡刺激素(FSH)、黄体生成素(LH),使用术前测值作为其自身对照,并以绝经年限分组进行分析。结果绝经后女性在预防性卵巢切除术后1月、术后半年、术后1年骨密度呈现出持续下降趋势,在术后1年时骨密度下降约11.6%;在预防性卵巢切除术后血清T浓度在术后1月时呈现下降趋势(P<0.05),后呈持续缓慢上升趋势,在术后1年时血清浓度与术前无明显差异。结论女性绝经后卵巢仍具备内分泌功能,若行预防性双侧卵巢切除术,将导致短时间内血清T下降,骨密度丢失明显加速。

Objective To investigate the effect of prophylactic ovariectomy on sex hormone level and bone mineral density in postmenopausal women.Methods From January 2019 to January 2021,58 postmenopausal women who needed total hysterectomy for benign uterine diseases and selected preventive resection of bilateral fallopian tubes and ovaries in Mianyang Central Hospital were selected.The bone mineral density(BMD)of lumbar spine and the levels of serum sex hormones,including estradiol(E2),testosterone(t)Follicle stimulating hormone(FSH)and luteinizing hormone(LH)were measured before operation as their own control,and analyzed by menopause years.Results The bone mineral density of postmenopausal women showed a continuous downward trend one month,half a year and one year after preventive oophorectomy,and decreased by about 11.2%one year after operation.The serum T concentration of postmenopausal women after preventive oophorectomy showed a downward trend at 1 month after operation(P<0.05),and then showed a continuous and slow upward trend.There was no significant difference between the serum concentration and that before operation at 1 year after operation.Conclusion Female postmenopausal ovaries still have endocrine function.If prophylactic bilateral oophorectomy is performed,serum T will decrease in a short time and bone mineral density loss will accelerate significantly.