目的:评价不同剂量雌激素在绝经后骨质疏松症治疗中的作用及对预后的影响.方法:90例绝经＜4年的妇女被随机分为三组(每组30例),A组给予倍美力0.3 mg+钙尔奇D片1g/d;B组给予倍美力0.625mg+钙尔奇D片1g/d;C组给予安慰荆+钙尔奇D片1g/d;连续用药1年.在用药前、用药后1年分别用超声骨密度仪追踪检测骨密度、血清骨代谢生化指标、B超监测子宫内膜增厚及乳房情况.结果:三组对象用药后骨痛均有不同程度改善;A组和B组用药后1年超声骨质测量中超声振幅衰减平均值和超声传播速度与治疗前相比无明显差异(P＞0.05),C组治疗前后比较有明显差异(P＜0.05).A、B组尿钙/肌酐、尿羟脯氨酸/肌酐比值的改变与用药前相比,差异有显著性(P＜0.05).三组对象治疗过程中其他观察指标如:乳腺B超、子宫内膜B超、阴道脱落细胞找癌细胞等均无显著性差异(P＞0.05).结论:绝经后妇女中,低剂量雌激素能有效防治骨质疏松症的发生.%Objective: To study the effect of different doses estrogen therapy on prevention and treatment of postmenopausal osteoporosis. Method: 90 cases postmenopausal women were randomly divided into 3 groups: Group A ( 30 cases ) received Premarin 0.3 mg+ Cahrate 1 g per day; Group B ( 30 cases ) received Premarin 0.3 mg + Cahrate 1 g per day; Group C ( 35 cases ) received placebo + Cahrate lg per day. Before the drug administration and 1 year after the treatment, the bone mineral density ( BMD ) of hip bone was measured by quantitative ultrasound measurement, the endometrium and breast tenderness were recorded by B-ultrasound, and the serum indexes of bone metabolism were recorded. Result: Bone pain of patients three groups has improved the varying degree. The broadband attenuation and the speed of sound ( SOS) in group A and B maintained no significant difference between before and after treatment. Those in group C were significantly different between before and after treatment ( P＜0.05 ). Ratio of urine calcium/ creatinine and hydroxyproline/creatinine in group A and B were significantly different between before and after treatment ( P＜0.05 ). Other observation indicators such as: breast B-ultrasound, endometrial B-ultrasound, vaginal exfoliated cells for cancer were no significant differences in three groups. Conclusion: Low dose of estrogen can prevent postmenopausal osteoporosis effectively and safely.
展开▼
