低雌激素妇女心血管疾病高危因素及骨密度状况分析
저자격소부녀심혈관질병고위인소급골밀도상황분석
Study on risk factors of cardiovascular disease and the status of bone mineral density in women with hypoestrogenism
  • 万方数据
    中华妇产科杂志 중화부산과잡지
    CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
    2013年 10期 734-739 ,共6页

    赵芳%郭雪桃%成贇%杨子芬%刘会平

    조방%곽설도%성빈%양자분%류회평

    绝经期%雌激素类%卵巢功能早衰%心血管疾病%骨密度%危险因素 絕經期%雌激素類%卵巢功能早衰%心血管疾病%骨密度%危險因素
    절경기%자격소류%란소공능조쇠%심혈관질병%골밀도%위험인소
    Menopause%Estrogens%Ovarian failure,premature%Cardiovascular diseases%Bone density%Risk factors
    目的 分析低雌激素妇女心血管疾病高危因素及骨密度状况.方法 回顾性分析2011年7月至2013年4月就诊于山西医科大学第一医院妇产科门诊的低雌激素妇女256例,分为绝经后组(133例)、卵巢早衰组(25例)、绝经过渡期组(67例)、卵巢早衰过渡期组(31例).比较4组患者绝经年限(仅包括绝经后组和卵巢早衰组)、绝经症状程度、心血管疾病高危因素(体质指数、血压、腰围、腰臀比、血脂和血糖水平)、骨密度等指标.结果 (1)绝经后组和卵巢早衰组中位绝经年限分别为3.4和3.6年,两组间比较,差异无统计学意义(P＞0.05)；绝经症状程度的中位Kupperman评分绝经后组、卵巢早衰组、绝经过渡期组、卵巢早衰过渡期组分别为12、9、9、8分,4组间比较,差异有统计学意义(P＜0.05).(2)4组间体质指数、腰围、腰臀比、舒张压比较,差异无统计学意义(P＞0.05)；中位收缩压绝经后组、卵巢早衰组、绝经过渡期组、卵巢早衰过渡期组分别为120、110、110、110 mm Hg(1 mm Hg=0.133 kPa),4组间比较,差异有统计学意义(P＜0.05)；绝经后组中位高密度脂蛋白(1.6 mmol/L)高于卵巢早衰组(1.3 mmol/L),差异有统计学意义(P＜0.05)；4组间空腹血糖比较,差异无统计学意义(P＞0.05).(3)绝经后组、卵巢早衰组、绝经过渡期组、卵巢早衰过渡期组(4组进行骨密度相关指标检测的患者分别为81、15、28、19例)腰椎骨量低下比例分别为57％(46/81)、8/15、32％(9/28)、12/19,骨质疏松症比例分别为9％(7/81)、3/15、11％(3/28)、0,2项指标4组间分别比较,差异均有统计学意义(P＜0.05)；左侧髋骨、腰椎骨密度异常率卵巢早衰组(分别为11/15、12/16)高于绝经后组[均为65％(53/81)],卵巢早衰过渡期组(分别为12/19、10/20)高于绝经过渡期组[43％(12/28)、39％(12/31)],分别比较,差异均有统计学意义(P＜0.05).结论 自然绝经后妇女因低雌激素引发的绝经症状最明显；绝经后骨密度的降低腰椎比左侧髋骨明显.早绝经比正常绝经妇女易发生血脂改变和骨密度异常,尤以高密度脂蛋白的降低明显,更易导致心血管疾病和骨质疏松症.
    목적 분석저자격소부녀심혈관질병고위인소급골밀도상황.방법 회고성분석2011년7월지2013년4월취진우산서의과대학제일의원부산과문진적저자격소부녀256례,분위절경후조(133례)、란소조쇠조(25례)、절경과도기조(67례)、란소조쇠과도기조(31례).비교4조환자절경년한(부포괄절경후조화란소조쇠조)、절경증상정도、심혈관질병고위인소(체질지수、혈압、요위、요둔비、혈지화혈당수평)、골밀도등지표.결과 (1)절경후조화란소조쇠조중위절경년한분별위3.4화3.6년,량조간비교,차이무통계학의의(P＞0.05)；절경증상정도적중위Kupperman평분절경후조、란소조쇠조、절경과도기조、란소조쇠과도기조분별위12、9、9、8분,4조간비교,차이유통계학의의(P＜0.05).(2)4조간체질지수、요위、요둔비、서장압비교,차이무통계학의의(P＞0.05)；중위수축압절경후조、란소조쇠조、절경과도기조、란소조쇠과도기조분별위120、110、110、110 mm Hg(1 mm Hg=0.133 kPa),4조간비교,차이유통계학의의(P＜0.05)；절경후조중위고밀도지단백(1.6 mmol/L)고우란소조쇠조(1.3 mmol/L),차이유통계학의의(P＜0.05)；4조간공복혈당비교,차이무통계학의의(P＞0.05).(3)절경후조、란소조쇠조、절경과도기조、란소조쇠과도기조(4조진행골밀도상관지표검측적환자분별위81、15、28、19례)요추골량저하비례분별위57％(46/81)、8/15、32％(9/28)、12/19,골질소송증비례분별위9％(7/81)、3/15、11％(3/28)、0,2항지표4조간분별비교,차이균유통계학의의(P＜0.05)；좌측관골、요추골밀도이상솔란소조쇠조(분별위11/15、12/16)고우절경후조[균위65％(53/81)],란소조쇠과도기조(분별위12/19、10/20)고우절경과도기조[43％(12/28)、39％(12/31)],분별비교,차이균유통계학의의(P＜0.05).결론 자연절경후부녀인저자격소인발적절경증상최명현；절경후골밀도적강저요추비좌측관골명현.조절경비정상절경부녀역발생혈지개변화골밀도이상,우이고밀도지단백적강저명현,경역도치심혈관질병화골질소송증.
    Objective To study risk factors of cardiovascular disease (CVD) and status of bone mineral density (BMD) in women with hypoestrogenism.Methods From Jul 2011 to April 2013,a total of 256 women with hypoestrogenism in the First Affiliated Hospital of Shanxi Medical University were enrolled in this retrospective study,which were divided into four groups:133 women in ppausal group,25 women in premature ovarian failure (POF) group,67 women in menopausal transition group and 31 women in premature ovarian failure transition group.General statue,CVD risk factors and BMD were compared among four groups.General statue include menopausal period,menopausal symptoms (Kupperman Index),CVD risk factors include body mass index,blood pressure,waist circumference,waist-hip ratio,blood lipids and glucose,BMD include left hip,lumbar spine bone mineral density and T or Z value.Results (1) The median menopausal period were 3.4 years in postmenopausal group and 3.6 years in premature ovarian failure group,which did not show no statistical difference (P ＞ 0.05).Kupperman Index in four groups were 12 in postmenopausal group,9 in POF group,9 in menopausal transition group and 8 in premature ovarian failure transition group,which reached statistical difference (P ＜ 0.05).(2) The difference of body mass index (BMI),waist circumference,waist-hip ratio,diastolic blood pressure were no statistically significant among four groups(P ＞ 0.05) ; the systolic blood pressure in four groups were 120,110,110,110 mm Hg (1 mm Hg =0.133 kPa),their differences were statistically significance (P ＜ 0.05); the high-density lipoprotein (HDL-C) was 1.6 mmol/L in postmenopausal group,and 1.3 mmol/L in premature ovarian failure transition group,their differences were all statistically significance (P ＜ 0.05) ; the difference of the fasting plasma glucose (FPG) was not statistically different in 4 groups (P ＞0.05).(3) The abnormal rate of lower bone mass in lumbar spine were 57％ (46/81) postmenopausal group,8/15 in POF group,32％ (9/28) in menopausal transition group,12/19 in premature ovarian failure transition group,and osteoporosis was 9％ (7/81),3/15,1％ (3/28)and 0 respectively,their differences were statistically different (P ＜ 0.05) ; the abnormal rate of BMD of left hip and lumbar spine of 11/15 and 12/16 in POF group was higher than 65％ (53/81) in postmenopausal group.In the mean time,the abnormal rate of BMD of left hip and lumbar spine were,12/19 and 10/20 in premature ovarian failure transition group,which were significantly higher than 43％ (12/28) and 39％ (12/31) in the menopausal transition group.Conclusions The menopausal symptoms resulting from hypoestrogenism in natural postmenopausal women are mostly remarkable.The decrease of BMD in lumbar spine is more significant than that of left hip among postmenopausal women.Women with earlier menopause was prone to cause the changes of blood fat and abnormal of BMD,especially HDL-C decreased significantly compared with those natural postmenopause,it is more likely to cause CVD and osteoporosis.
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