绝经激素治疗对绝经期女性骨转换标志物的影响  

Effects of Menopausal Hormone Therapy on Bone Turnover Markers in Menopausal Women

作　　者：王威[1] 胡红霞 孙晓乐[1] 耿力[1] 李蓉[1] 周江华 毕仙民 梁菊艳 闫小艳[1] WANG Wei;HU Hongxia;SUN Xiaole(Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院妇产科,北京100191

出　　处：《实用妇产科杂志》2025年第2期125-129,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:了解绝经激素治疗(MHT)对绝经期女性骨转换标志物(BTMs)的影响,探讨BTMs作为MTH的疗效监测指标的可行性。方法:2018年1月至2022年8月在本院更年期门诊及妇科内分泌门诊就诊的绝经期女性,接受MHT并定期复查BTMs的患者。根据启动MHT时的治疗方案分为雌激素组(连续序贯治疗或连续联合治疗)及替勃龙组。所有患者在治疗前及治疗后6、12及24个月均复查BTMs,包括骨钙素(OC)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、血清I型原胶原N端前肽(P1NP)。同时收集其在本院的骨密度检查结果。比较各组治疗前与治疗后BTMs情况和两组治疗后BTMs较治疗前的变化量,同时分析骨密度的变化情况。结果:雌激素组和替勃龙组治疗后6、12、24个月BTMs(β-CTX、P1NP、OC)水平及异常率均较治疗前明显降低,差异有统计学意义(P<0.05),两组间比较治疗后BTMs较治疗前的变化量,差异无统计学意义(P>0.05)。治疗后12、24个月患者骨量减少及骨质疏松的发生率较治疗前无明显改变,差异无统计学意义(P>0.05),腰椎骨密度在MHT治疗后12、24个月较治疗前增高,差异有统计学意义(P<0.05),股骨颈及髋骨骨密度在MHT治疗后12、24个月较治疗前无明显变化(P>0.05)。结论:两种MHT方案抗骨吸收效果相似,BTMs(OC、β-CTX、P1NP)在治疗6月后明显降低并能维持效果,BTMs可作为MHT效果的重要监测方法之一。Objective:To understand the impact of menopausal hormone therapy(MHT)on bone turnover markers(BTMs)in menopausal women and explore the feasibility of BTMs as efficacy monitoring indicators for MHT.Methods:Menopausal women who visited the Menopause Clinic and Gynecological Endocrine Clinic of our hospital from January 2018 to August 2022,received MHT and had regular reexaminations of BTMs were selected.According to the treatment plan at the initiation of MHT,they were divided into the estrogen group(continuous or cyclic sequential therapy or continuous combined therapy)and the tibolone group.All patients had reexaminations of BTMs,including osteocalcin(OC),beta C-terminal telopeptide of type Ⅰ collagen(β-CTX),and procollagen type I N-terminal propeptide(P1NP),before treatment and at 6 months,12 months and 24 months after treatment.Meanwhile,their bone mineral density examination results in our hospital were collected.The BTMs before and after treatment in each group were compared,as well as the changes in BTMs after treatment compared with those before treatment between the two groups.Meanwhile,the changes in bone mineral density were analyzed.Results:The levels and abnormal rates of BTMs(β-CTX,P1NP,OC)in both the estrogen group and the tibolone group were significantly decreased at 6,12,and 24 months after treatment compared with those before treatment,and the differences were statistically significant(P<0.05).When comparing the changes in BTMs after treatment compared with those before treatment between the two groups,there was no statistically significant difference(P>0.05).The incidences of osteopenia and osteoporosis in patients at 12 months and 24 months after treatment had no significant changes compared with those before treatment,and the differences were not statistically significant(P>0.05).The lumbar spine bone mineral density was significantly improved at 12 months and 24 months after MHT treatment compared with that before treatment,and the differences were statistically significant(P<0.05).The bo

关 键 词：绝经激素治疗 绝经后女性 骨转换标志物 骨密度 

分 类 号：R711[医药卫生—妇产科学]