CAJ | 학술논문

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2002年3月至2003年3月诊治的90例绝经妇女随机分为3组,A组(31例):每日服用戊酸雌二醇1 mg+醋酸甲羟孕酮2 mg;B组(29例):每日服用结合雌激素0.45 mg+醋酸甲羟孕酮2 mg;C组(30例):每日服用7-甲异炔诺酮1.25 mg,共服药12个月.各组均每日服用元素钙400 mg.治疗前后分别测定第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)值及血清总碱性磷酸酶(ALP)水平.结果治疗12个月时B组L2～4骨密度上升显著(上升0.039 g/cm2,P<0.01),A与C组骨密度变化不明显(均P>0.05);治疗后L2～4骨密度B组与A组、C组比较差异均有统计学意义(均P<0.05),A组和C组之间差异无统计学意义(P>0.05).治疗6个月3组尿NTX/Cr值均下降,其中B组、C组下降明显(均P<0.05),组间比较差异均无统计学意义(P>0.05).治疗12个月时各组血ALP水平均明显下降(P<0.01),下降程度相似(P>0.05).结论 3种低于标准剂量的性激素治疗12个月均可对抗绝经后妇女骨量丢失.
목적 탐토저제량성격소치료방안대절경후부녀골량주실적영향.방법 장2002년3월지2003년3월진치적90례절경부녀수궤분위3조,A조(31례):매일복용무산자이순1 mg+작산갑간잉동2 mg;B조(29례):매일복용결합자격소0.45 mg+작산갑간잉동2 mg;C조(30례):매일복용7-갑이결낙동1.25 mg,공복약12개월.각조균매일복용원소개400 mg.치료전후분별측정제2～4요추골(L2～4)골밀도、골대사생화지표뇨N단교련다태/기항(NTX/Cr)치급혈청총감성린산매(ALP)수평.결과 치료12개월시B조L2～4골밀도상승현저(상승0.039 g/cm2,P<0.01),A여C조골밀도변화불명현(균P>0.05);치료후L2～4골밀도B조여A조、C조비교차이균유통계학의의(균P<0.05),A조화C조지간차이무통계학의의(P>0.05).치료6개월3조뇨NTX/Cr치균하강,기중B조、C조하강명현(균P<0.05),조간비교차이균무통계학의의(P>0.05).치료12개월시각조혈ALP수평균명현하강(P<0.01),하강정도상사(P>0.05).결론 3충저우표준제량적성격소치료12개월균가대항절경후부녀골량주실.
Objective To determine the effects of sexual hormone therapy at varied doses on prevention of bone mineral loss in Chinese postmenopausal women. Methods From March 2002 to March 2003, 90 Chinese postmenopausal women were randomly divided into three groups, each given one of the following regiments for 12 months, estradiol valerate (EV) 1 mg plus medroxyprogesterone (MPA) 2 mg for group A (31 subjects), eonjngated estradiol (ethinylestradiol-3-cyclopentylether, CEE) 0.45 mg plus MPA 2 mg for group B (29 subjects) and livial 1.25 mg for group C (30 subjects), respectively. In addition, 400 mg of elemental calcium were given daily to all those women. Bone mineral density (BMD) of the 2nd to 4th lumbar vertebra (L2～4) and biochemical markers of bone turnover, urine N-telopeptide of type Ⅰ collagen/creatinine(NTX/Cr) and serum total alkaline phnsphatase (ALP), were measured before and after drug administration. Results After treatment for 12 months, BMD of the L2～4 increased significantly by 0.039 g/cm2(P<0.01) in group B, but not significantly in group A or group C (P<0.05). Increases in BMD of the L2～4 was more in group B than that in group A and group C, respectively (P < 0.05), but no significant difference in BMD increase between group A and group C was found (P >0.05). After treatment for 6 months, urine NTX/Cr reduced from the baseline for all the three groups (P < 0.05), but no significant difference among group A, group B and group C was found (P >0.05). After treatment for 12 months, serum ALP significantly reduced from the baseline for all the three groups (P <0.01), but no significant difference among group A, group B and group C wag found (P > 0.05). Conclusions Sexual hormone therapy at varied doses lower than regular one for 12 months was effective in preventing bone mineral less in postmenopausal women.