口服碳酸钙制剂对孕产妇骨密度的影响

目的探讨孕产妇补充碳酸钙制剂对其骨密度的影响。方法36例孕第一胎妇女从孕20周开始通过膳食、膳食干预及碳酸钙补充摄入不同剂量的钙至产后45天。监测并比较孕中、孕末及产后期的血钙、碱性磷酸酶、尿羟脯氨酸、骨钙素及产后骨密度的差异。结果(1)传统膳食加40g／d奶粉补充的孕产妇产后骨密度虽优于传统膳食组，但明显低于奶粉加碳酸钙组；(2)奶粉加碳酸钙补充组的产妇腰椎骨密度明显高于奶粉组和传统膳食组，并维持至正常非常非孕同龄妇女的水平；(3)奶粉加碳酸钙补充组在孕末期、产后期的碱性磷酸酶活性、尿羟脯氨酸水均明显低于传统膳食组而骨钙素含量明显高于传统膳食组。结论(1)我国传统膳食钙摄入量约450mg／d，孕期的低钙摄入可导致产后骨密度下降；(2)孕期在传统膳食基础上补充40g奶粉／d，可使其产后骨密度优于传统膳食组，但不能维持骨密度至正常的水平；(3)奶粉加碳酸钙的联合补充，可使孕产妇产后骨密度明显高于传统膳食组和奶粉补充组，并维持其骨密度至正常水平。

Effect of calcium carbonate supplementation on bone mineral density in pregnant and parturient women

Objective To study the effect of calcium carbonate supplementation on bone mineral density and calcium metabolism in pregnancy and parturition. Methods According to different levels of calcium intake,36 healthy pregnant women were randomly divided into three groups.The indices related to bone mineral density,calcium metabolism and osteocalcin were measured. Results (1) The mothers' lumbar bone mineral density in the calcium carbonate group was higher significantly than in the milkpowder group and the control group ( P <0.05).(2)Serum alkaline phosphatase activity and urine hydroxyproline excretion of later pregnancy and after parturition in the calcium carbonate group were lower significantly than those in the control group (P <0.05).(3)Osteocalcin in the calcium carbonate group was higher significantly than that in the control group (P <0.05). Conclusions (1)Calcium content in the traditional diet of Chinese pregnant and parturient women is lower significantly than that in Chinese RDA.(2) Not only calcium milk powder but also calcium carbonate supplement must be emphasized in pregnancy.(3) Caltrate D supplementation can increase bone mineral density in pregnant and parturient women is a recommended calcium carbonte supplement.