HRT加用雄激素对绝经后妇女骨代谢影响的探讨

探讨雌孕激素替代治疗加用雄激素类药对绝经后妇女骨密度和骨代谢指标的影响及其治疗安全性。方法 :85例绝经后健康妇女随机分为两组 :试验组 4 5例 ,每日口服倍美安 (含天然结合型雌激素 0 .6 2 5 mg+醋酸甲羟孕酮 2 .5 mg) 1粒 +去氢甲基睾丸素 2 mg;对照组 4 0例 ,每日口服倍美安 1粒 ,两组均服药 8w,观察两组妇女用药前及用药 4 w末、8w末、用药后 1月、2月各观察点的骨密度值、血清碱性磷酸酶、尿羟脯氨酸 /肌酐、尿钙 /肌酐比值及血脂、副反应等。结果 :1两组治疗过程骨密度值均逐渐升高 ,尿羟脯氨酸 /肌酐、尿钙 /肌酐比值逐渐降低 ,用药 4 w末、8w末、用药后 1月两组间比较有显著性差异。2两组治疗过程血胆固醇、血甘油三酯、低密度脂蛋白逐渐下降 ,试验组改善脂质代谢的特点未受影响。3两组在治疗副反应上比较差异无显著性。结论 :绝经后妇女雌孕激素替代治疗中加入雄激素类药可以提高骨量 ,减少骨丢失。对血脂代谢无不利影响。是一种防治绝经后骨质疏松的安全有效的方法

The effects of adding Androgen in HRT upon bone metabolism in postmenopausal women

Objective:To study the effects and therapeutic safety of adding Androgen in Estrogen and Progestin replacement therapy in postmenopausal women upon bone mineral density and biochemical bone markers Methods:85 naturally menopausal healthy women were randomly divided into two groups : 45 cases as experimental group, they are required to take Premelle (including naturalconjugated estrogen 0 625 mg Medroxyprogesterone acetate 2 5 mg ) orally one pill plus Metandienone 2 mg daily Whereas the 40 cases in the comparison group, they are required to take Premelle one pill each day only The treatments of two groups lasted for 8 weeks The side reactions and bone mineral density,serum alkaline phosphate and ratio of urinary hydroxyproline / creatinine, urinary calcium / creatinine andserum lipid profile were evaluated at baseline and four weeks, eight weeks during the treatment, one month and two months after the treatment Results:1 The bone mineral density in both groups keeped increasing while being in the treatment and the ratio of urinary hydroxyproline / creatinine, urinary calcium/ creatinine keeped declining The difference between the two groups was significant in four weeks, eight weeks during taking treatment and one month after treatment 2 During the process, the serum Cholesterin, serum Triglyceride, and Low Density Lipoprotein are declining gradually, whereas the features of improving lipid metabolism are not affected for the experimental group 3 There was no significant difference between the two grups in the process of side reactions Conclusion:Adding Androgen in Estrogen and Progestin replacement therapy in postmenopausal women can improve bone quality, and reduce losses of that, which has no side effect on blood lipid metabolism It is sure a safe and effective way of preventing the menopausal osteoporosis