雌二醇与孕激素预防绝经近期妇女骨量丢失的观察

Observation on the estradiol and progesterone in the prevention of bone mass loss in early postmenopausal women

  • 摘要: 目的:探讨低剂量性激素治疗方案对绝经后妇女骨量丢失的影响。方法将85例绝经妇女随机分为3组,A 组(30例):每日服用戊酸雌二醇(E2V)1.0 mg+醋酸甲羟孕酮(MPA)2.0 mg;B 组(30例):每日服用结合雌激素(CEE)0.45 mg+醋酸 MPA 2.0 mg;C 组(对照组,25例):维生素(VitD)200 IU /d;共服药12个月。各组均每日服用元素钙400 mg。观察3组治疗前后第2-4腰椎骨(L2-4)骨密度、骨代谢生化指标尿 N 端交联多肽/肌酐(NTX /Cr)值,骨折发生率。结果治疗12个月时 B 组 L2~4骨密度上升显著,A 组与 C 组骨密度变化不明显;治疗6个月3组尿 NTX /Cr 值均下降,其中 B 组下降明显。除 B 组与 C 组尿 NTX /Cr 值间差异有统计学意义之外,其余各组间均无统计学意义。结论国产 E2V 1 mg 配伍 MPA 2 mg /d可有效预防绝经后骨丢失。每日 CEE 0.45 mg 与 MPA 2 mg 合用对多数人较合适。

     

    Abstract: Objective To explore the influence of low-dose sex hormone on bone mass loss for postmenopausal women.Methods A total of 85 postmenopausal women were randomly divided into group A,group B and group C.Group A (n =30)was given 1.0 mg estradiol valerate (E2V) and 2.0 mg medroxyprogesterone (MPA)every day.Group B (n =30)was conducted 0.45 mg conjugated estradiol (ethinylestradiol-3-cyclopentylether,CEE)and 2.0 mg MPA every day and group C (control group,n =25)was given vitamin (VitD)200 IU every day.The administration of drugs for each group was 12 months.In addition,400 mg elemental calcium was given daily to all women in the three groups.Bone mineral density (BMD)from the second to the fourth lumbar ver-tebra (L2-4),metabolic bone biochemical markers,urine N-telopeptide /creatinine (NTX /Cr)and incidence of bone fracture were observed before and after drug administration.Results After treat-ment of 12 months,BMD of L2 to L4 increased significantly in group B while it did not increased significantly in groups A and group C.After treatment for 6 months,urine NTX /Cr reduced in the 3 groups,in which the decreased range in group B was the most significant.The difference was sta-tistically significant in NTX /Cr value of group B and group C and there were no significant differ-ence in other groups.Conclusion Domestic E2V for 1 mg combined with 2 mg MPA every day can effectively prevent postmenopausal bone mass loss,and daily administration of CEE for 0.45 mg and MPA for 2 mg is favorable for most postmenopausal women.

     

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