HRT治疗围绝经期女性骨质疏松症对患者骨代谢标志物水平及安全性分析

Analysis of the level and safety of bone metabolism markers in patients with perimenopausal female osteoporosis treatedwithHRT

目的研究激素替代疗法(HRT)治疗围绝经期女性骨质疏松症对其骨代谢标志物水平以及安全性的影响效果。方法选取60例围绝经期女性骨质疏松症患者,按照随机数字表法分为对照组和观察组,每组30例。对照组给予阿仑膦酸钠治疗,观察组在对照组基础上联合HRT进行治疗。比较两组患者治疗前后骨密度(BMD)、雌二醇(E_(2))、卵泡刺激素(FSH)、骨特异性碱性磷酸酶(BAP);治疗前后Ⅰ型原胶原N-端前肽(PINP)、Ⅰ型胶原交联C-末端肽(S-CTX);不良反应发生情况。结果治疗前,两组患者的BMD、E_(2)、FSH、BAP水平比较,差异均无统计学意义(P>0.05);治疗后,观察组患者的BMD、E_(2)、FSH、BAP水平均显著优于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的PINP、S-CTX指标比较,差异均无统计学意义(P>0.05);治疗后,观察组患者的PINP、S-CTX指标均显著低于对照组,差异有统计学意义(P<0.05)。观察组患者的不良反应发生率3.3%显著低于对照组的20.0%,差异有统计学意义(P<0.05)。结论围绝经期女性骨质疏松症患者通过HRT治疗后,可改善骨代谢标志物水平,提升治疗安全性,值得临床推广。

Objective To investigate the effect of hormone replacement therapy(HRT)on the level and safety of bone metabolism markers in perimenopausal women with osteoporosis.Methods 60 cases of perimenopausal female osteoporosis patients were selected and divided into control group and observation group according to random number table method.The control group was treated with alendronate sodium,and the observation group was treated with HRT.The bone mineral density(BMD),estradiol(E2),follicle-stimulating hormone(FSH)and bone-specific alkaline phosphatase(BAP)type I procollagen N-terminal propeptide(PINP),type I collagen cross-linked C-terminal peptide(S-CTx)before and after treatment,the complication occurrence were compared between the two groups.Results Before treatment,there were no significant differences in BMD,E2,FSH and BAP levels between 2 groups(P>0.05).After treatment,BMD,E2,FSH and BAP levels in observation group were significantly better than those in control group,with statistical significance(P<0.05).Before treatment,there was no significant difference in PINP and S-CTX between 2 groups(P>0.05).After treatment,PINP and S-CTX in observation group were significantly lower than those in control group,with statistical significance(P<0.05).The incidence of adverse reactions in observation group(3.3%)was significantly lower than that in control group(20.0%),and the difference was statistically significant(P<0.05).Conclusion HRT therapy can improve the level of bone metabolism markers and improve treatment safety in perimenopausal women with osteoporosis,which is worthy of promotion.