不同剂量雌激素联合地屈孕酮治疗围绝经期综合征的效果及对患者骨密度的影响  

Effect of different doses of estrogen combined with dydrogesterone on perimenopausal syndrome and its influence on bone mineral density

作　　者：马莉[1] 纪元元[1] 白睿敏[1] 梁芳[2] Ma Li;Ji Yuanyuan;Bai Ruimin;Liang Fang(Department of Gynecology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450006,China)

机构地区：[1]郑州大学第一附属医院妇科,郑州450006 [2]郑州大学第一附属医院内科,郑州450006

出　　处：《中国实用医刊》2023年第20期100-103,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析不同剂量雌激素联合地屈孕酮治疗围绝经期综合征(PMS)的效果及对患者骨密度的影响。方法抽取2020年5月至2022年5月郑州大学第一附属医院收治的66例PMS患者,按随机数字表法分为对照组与研究组,每组33例。对照组给予标准剂量雌激素联合地屈孕酮治疗,研究组给予低剂量雌激素联合地屈孕酮治疗。对比两组临床疗效、卵巢功能、骨密度及不良反应发生率。结果研究组总有效率(84.85%,28/33)与对照组(87.88%,29/33)比较差异未见统计学意义(P>0.05)。治疗后,研究组促卵泡激素水平高于对照组,雌二醇水平低于对照组(P<0.05);治疗前后,两组第1~4腰椎、双侧股骨骨密度比较差异未见统计学意义(P>0.05)。研究组不良反应发生率(3.03%,1/33)低于对照组(24.24%,8/33),P<0.05。结论PMS患者应用标准剂量或低剂量雌激素与地屈孕酮联合治疗的疗效相当,均可对性激素起到改善作用,且不会对骨密度造成影响,低剂量雌激素联合地屈孕酮治疗的不良反应更少,安全性更高。ObjectiveTo analyze the effect of different doses of estrogen combined with dydrogesterone on patients with perimenopausal syndrome(PMS)and its influence on bone mineral density.MethodsSixty-six patients with PMS admitted to the First Affiliated Hospital of Zhengzhou University from May 2020 to May 2022 were selected,and they were divide into control group and study group using random number table method,with 33 cases in each group.The control group was treated with standard-dose estrogen combined with dydrogesterone,while the study group was treated with low-dose estrogen combined with dydrogesterone.The clinical efficacy,ovarian function,bone mineral density and incidence of adverse reactions were compared between the two groups.ResultsThere was no statistically significant difference in the total effective rate between the study group(84.85%,28/33)and the control group(87.88%,29/33),P>0.05.The study group had higher level of follicle stimulating hormone and lower level of estradiol 2 than the control group after treatment(P<0.05).There was no statistically significant difference in the bone density of 1st to 4th lumber vertebrae and bone density of bilateral femoral necks before and after treatment in the two groups(P>0.05).The incidence of adverse reactions in the study group(3.03%,1/33)was lower than that in the control group(24.24%,8/33),P<0.05.ConclusionsStandard-dose or low-dose estrogen in combination with dydrogesterone have comparable efficacy in the treatment of PMS patients,both of which can improve sex hormones and do not affect bone density.Low-dose estrogen in combination with dydrogesterone has fewer adverse reactions,and it is safer.

关 键 词：雌激素 围绝经期综合征 地屈孕酮 骨密度 雌二醇 促卵泡激素 

分 类 号：R711.75[医药卫生—妇产科学]