摘要
目的观察绝经激素治疗(MHT)对绝经综合征患者围绝经期症状的改善效果和对骨密度(BMD)的影响,分析MHT对围绝经期患者的综合收益。方法选取2018年7月至2022年7月就诊于宁夏医科大学总医院生殖内分泌门诊BMD减低的绝经综合征患者232例,按谈话后是否自愿接受MHT将其分为研究组(MHT组,n=106)和对照组(非MHT组,n=126)。对照组仅口服钙剂和维生素D,研究组在口服钙剂和维生素D基础上添加雌孕激素。于治疗前、治疗后采用改良Kupperman评分表评估患者围绝经期症状,并测定腰椎1~4及股骨颈的BMD。结果最终完成试验共218例,其中研究组100例、对照组118例,脱失率6.03%(14/232)。治疗前两组患者间改良Kupperman评分及各检测部位的BMD比较均无显著差异(P>0.05)。研究组治疗后6个月和治疗后1年改良Kupperman评分较治疗前显著减低(P<0.05),且均达正常值;对照组患者治疗后Kupperman评分均较治疗前略有降低,但均无显著性差异(P>0.05)。研究组治疗后BMD均较治疗前升高,治疗后1年BMD较治疗前显著升高(P<0.05);对照组治疗后BMD均较治疗前有所升高,但均无显著性差异(P>0.05)。结论绝经激素治疗在绝经综合征患者中的应用可明显改善围绝经期症状,同时可增加腰椎及股骨颈的骨密度,从而改善和预防骨质疏松,大大提高围绝经期妇女的生活质量,增加其临床获益。
Objective:To observe the effect of menopausal hormone therapy(MHT)on the improvement of perimenopausal symptoms and bone mineral density(BMD),and to analyze the comprehensive benefits of MHT on perimenopausal patients.Methods:A total of 232 menopausal syndrome patients with decreased BMD who were admitted to the Reproductive endocrinology Clinic of Ningxia Medical University General Hospital from July 2018 to July 2022 were selected and divided into the study group(MHT group,n=106)and the control group(non-MHT group,n=126)according to whether they voluntarily accepted MHT after the interview.The control group only took oral calcium and vitamin D,and the study group added estrogen and progesterone on the basis of oral calcium and vitamin D.The improvement of perimenopausal symptoms was evaluated by using the modified Kupperman score scale before and after treatment,and BMD of lumbar spine 1-4 and femoral neck were measured.Results:A total of 218 cases were recruited,including 100 cases in the study group and 118 cases in the control group,with a loss rate of 6.03%(14/232).Before treatment,there were no significant differences in the modified Kupperman score and BMD at each test site between the two groups(P>0.05).The modified Kupperman scores at 6 months and 1 year after treatment in the study group were significantly lower than those before treatment(P<0.05),reaching normal values.In the control group,Kupperman score after treatment was slightly lower than that before treatment,showing no statistical difference(P>0.05).In the study group,BMD after treatment was higher than that before treatment,and BMD after 1 year was significantly higher than that before treatment(P<0.05).In the control group,BMD after treatment was higher than that before treatment,but showing no statistical difference(P>0.05).Conclusions:The application of menopausal hormone therapy in patients with menopausal syndrome can significantly improve the symptoms of perimenopause,and increase the bone mineral density of lumbar spine and femoral neck,so as to improve and prevent osteoporosis,greatly promote the quality of life of perimenopausal women and increase their clinical benefits.
作者
宋梦玲
魏松英
高慧敏
胡蓉
SONG Meng-ling;WEI Song-ying;GAO Hui-min;HU Rong(Reproductive Medicine Center of Ningxia Medical University General Hospital,Yinchuan 750004;People’s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750001;The First Clinical Medical College of Ningxia Medical University,Yinchuan 750004)
出处
《生殖医学杂志》
CAS
2024年第9期1153-1158,共6页
Journal of Reproductive Medicine
基金
宁夏自然科学基金重点项目(2021AAC02026)
宁夏自治区科技惠民计划项目(2023CMG03023)。
关键词
绝经激素治疗
围绝经期
骨密度
骨质疏松
个体化
Menopausal hormone therapy
Perimenopause
Bone mineral density
Osteoporosis
Individuation
