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目的 探讨雌激素替代治疗 (ERT)在预防和治疗绝经后骨质疏松症 (POP)中的作用。方法 选择 46例双侧卵巢切除妇女为研究对象 ,年龄 34～ 5 3岁 ,其中 2 5例于手术后 6个月内开始口服结合雌激素 (倍美力 0 .3～ 0 .6 2 5mg/d)和钙片 (钙尔奇 D 6 0 0mg/d)作为治疗组 ,另 2 1例仅口服钙片为对照组。随访时间为 14～ 2 5个月。应用双能X线骨密度仪于随访开始和结束时分别测定腰椎及股骨颈的骨密度 (BMD)变化 ,并同时测定血液中雌二醇 (E2 )、卵泡刺激素 (FSH)、碱性磷酸酶(AKP)、骨钙素 (BGP)、血钙和血磷等指标。结果 治疗组用药后L2～ 4 BMD、E2 水平明显高于用药前及对照组 ,AKP、BGP、血钙水平明显低于用药前及对照组 ,而对照组明显升高 ,血磷水平各组变化不明显。结论 妇女绝经后E2 水平下降是造成绝经后POP的主要原因 ;BMD测定和E2 、AKP、BGP等可以早期诊断POP ;ERT可以有效预防和治疗POP。
Objective To investigate the role of estrogen replacement therapy (ERT) in the prevention and treatment of postmenopausal osteoporosis (POP). Methods Forty-six women with bilateral ovariectomy were selected as study subjects, aged 34-53 years. Twenty-five of them received oral administration of estrogen orally within 6 months after operation (Bei Meili 0.3 ~ 0.655 mg / d) and calcium tablets (Calcium D 60 mg / d) as the treatment group, the other 21 cases of oral calcium alone as the control group. Follow-up time was 14 ~ 25 months. The bone mineral density (BMD) of the lumbar spine and femoral neck were measured by dual energy X-ray absorptiometry at the beginning and the end of the follow-up. The blood estradiol (E2), follicle stimulating hormone (FSH), alkaline phosphatase Enzyme (AKP), osteocalcin (BGP), serum calcium and phosphorus and other indicators. Results After treatment, the levels of L2 ~ 4 BMD and E2 in the treatment group were significantly higher than those before treatment and in the control group. The levels of AKP, BGP and serum calcium in the treatment group were significantly lower than those before treatment and in the control group, while those in the control group were significantly increased Not obvious. Conclusions The decline of E2 in postmenopausal women is the main cause of postmenopausal POP. BMD and E2, AKP and BGP can be used to diagnose POP early. ERT can effectively prevent and treat POP.