女性不同绝经年龄骨密度和骨强度256例分析

目的　研究绝经年龄对女性骨密度和骨强度的影响 ,为骨质疏松症 (OP)的预防提供科学依据。方法　采用双能X线骨密度仪和骨超声仪 ,测量 2 5 6例绝经年限 10～ 2 5年的健康女性志愿者骨密度 (BMD)和胫骨超声传导速度 (SOS) ,按绝经年龄不同分为Ⅰ组 (绝经年龄 <4 5岁 )、Ⅱ组 (绝经年龄 4 5～ 5 1岁 )、Ⅲ组 (绝经年龄>5 1岁 )进行分析。结果　三组除腰椎正、侧位 ,髋部wards区 ,尺骨和桡骨超远端外 ,其他部位BMD均与绝经年龄呈正相关 (r =0 10 7～ 0 2 11,P <0 0 5或P <0 0 1) ;Ⅱ、Ⅲ组髋部股骨颈、髋部总体、尺骨和桡骨远端 1/ 3段、尺骨和桡骨总体BMD均高于Ⅰ组对应部位 (P <0 0 5或P <0 0 1) ,且OP的患病率均低于Ⅰ组 (P <0 0 5或P <0 0 1) ;Ⅱ、Ⅲ组之间各部位BMD以及OP的患病率差异无显著性意义 ;胫骨SOS值与绝经年龄无相关性 ,且Ⅰ、Ⅱ、Ⅲ组之间胫骨SOS值以及OP的患病率差异无显著性意义 (P >0 0 5 )。结论　绝经年龄早 (<4 5岁 )主要引起皮质骨BMD降低 (腰椎正位除外 ) ,对松质骨BMD影响小 ;正常和晚绝经年龄对BMD影响小 ;绝经年龄对骨强度影响小     

绝经后骨质疏松症

妇女一生中有１／３的时间处于绝经期，在这段时间里机体出现一系列病理生理变化，其中绝经后骨质疏松症（ｐｏｓｔｍｅｎｏｐａｕｓａｌｏｓｔｅｏｐｏｒｏｓｉｓ，ＰＯ）极为常见。有资料表明，绝经后妇女约１／３～１／２罹患ＰＯ，严重的ＰＯ患者易并发骨折（ｂｏｎｅ...     

绝经后骨质疏松症的防治动向

骨质丢失严重威胁绝经后妇女健康,对症治疗措施有:降钙素(100IU/d)皮下注射,服用氟化钠(50mg/d)及 etidronate(400mg/d)等。单纯对症治疗不能使骨小梁结构恢复正常,应采取预防性措施,包括对绝经后不久的妇女施以激素替代疗法(口服结合雌激素),补充钙剂(1500mg/d)以及适当的运动等,上述措施近期效果满意,远期效果仍需观察。     

上海市浦东新区妇女绝经年龄及行经年限调查与影响因素分析

目的 调查上海市浦东新区妇女的自然绝经年龄、行经年限,观察初潮年龄与生育次数对自然绝经年龄和行经年限的影响.方法 2007年1月至2008年7月,以参加上海市浦东新区宫颈癌筛查的、年龄≥56岁的15 083例自然绝经妇女为研究对象,采用一对一的问卷方式,调查妇女的初潮年龄、生育次数、自然绝经年龄、行径年限等情况.将研究对象按年龄分为56～60、61～65、66～70和>70岁4个组.采用方差分析方法,比较各年龄组绝经年龄和行经年限的差异;采用多因素回归方法分析年龄组别、初潮年龄、生育次数与绝经年龄和行经年限的关系.结果 (1)自然绝经年龄:最小为29岁,最大为61岁,平均为(50.6±3.7)岁.56～60、61～65、66～70和>70岁4个年龄组的平均绝经年龄分别为(50.9±3.4)、(50.7±3.7)、(50.0±4.1)、(49.6±4.0)岁,随着年龄组的年轻化,平均绝经年龄呈逐渐增加趋势,最小年龄组与最大年龄组比较,平均绝经年龄相差1.36岁.(2)行经年限:最长为48年,最短为12年,平均(34.3±4.1)年.56～60、61～65、66～70和>70岁组的平均行经年限分别为(34.6±3.8)、(34.3±4.1)、(33.9±4.6)、(33.2±4.5)年;随着年龄组的年轻化,平均行经年限呈逐渐延长趋势,最大年龄组与最小年龄组比较,相差1.41年.(3)初潮年龄对绝经年龄和行经年限的影响:相关分析显示,初潮年龄与绝经年龄无明显相关性(r=0.02),初潮年龄与行经年限呈负相关(r=-0.43).(4)生育次数对绝经年龄和行经年限的影响:生育1～2次妇女的绝经年龄明显高于生育0次和≥3次的妇女,差异有统计学意义(P<0.05);但生育1次与2次的妇女及生育0次与≥3次的妇女绝经年龄比较,差异均无统计学意义(P>0.05).生育1次的妇女行经年限明显长于生育1次以上的妇女,生育2次的妇女行经年限明显长于生育0次和≥3次的妇女,差异也有统计学意义(P<0.05);生育0次与≥3次者行经年限比较,差异无统计学意义(P>0.05).(5)行经年限的多因素回归分析:初潮年龄与行经年限呈明显的负相关(r=-0.97,P<0.001);不同年龄组别的行经年限相关分析显示,61～65、66～70和>70岁组与56～60岁组比较,差异均有统计学意义(r=-0.18,P=0.020、r=-0.78,P<0.001和r=-1.23,P<0.001);生育1～2次者的行经年限明显长于生育0次和≥3次者.(6)绝经年龄的多因素回归分析:初潮年龄与绝经年龄无相关性(r=0.02);但不同年龄组别的绝经年龄的多因素分析显示,61-65、66～70和>70岁组妇女的绝经年龄与56～60岁组比较,差异也有统计学意义(r=-0.18,P=0.020、r=-0.78,P<0.001、r=-1.23,P<0.001).生育1～2次的妇女绝经年龄明显高于生育0次和≥3次者,但生育1次与2次,0次与≥3次者间比较,差异均无统计学意义.结论 (1)上海市浦东新区妇女的绝经年龄逐渐增加,行经年限呈延长趋势;(2)初潮年龄和生育次数是影响绝经年龄和行经年限的重要因素;(3)随着初潮年龄的年轻化,行经年限逐渐延长;(4)生育1～2次能明显推迟绝经年龄并且延长行经年限,而多次生育(≥3次)对绝经年龄和行经年限均无明显影响.     

北京市城区1400例妇女腰椎骨量与年龄和绝经的关系

目的：分析妇女的腰椎骨量变化规律，为防治骨质疏松症提供依据。方法：对１４００例２０～８５岁居住在北京市城区的妇女，采用双能Ｘ线骨密度测定仪（ＤＥＸＡ）测量第１～４腰椎的骨矿含量（ＢＭＣ）和骨密度（ＢＭＤ）。结果：（１）ＢＭＣ和ＢＭＤ在３０岁以前随年龄增长而增加，３０岁达高峰，５０岁以后显著下降。（２）绝经前妇女，ＢＭＣ和ＢＭＤ达峰值后不随年龄增长有显著下降，绝经后１０年内出现快速骨丢失，早绝经妇女的骨量较低（Ｐ＜０．０５）。（３）绝经后骨质疏松症患病率１７．４０％。结论：绝经后１０年内出现快速骨丢失，此期是防治骨质疏松症的关键时期。     

上海市浦东新区妇女绝经年龄及行经年限调查与影响因素分析

Objective To investigate natural spontaneous menopausal age , menstruation span and their relationship with menarche age and parity in Pudong district of Shanghai. Methods From Jan 2007 to Jul 2008, 15 083 spontaneous menopause women undergoing cervical cancer screening were enrolled in this study. The questionnaire included menarche age, parity, spontaneous menopausal age and menstruation span. Those women were divided into four groups based on age, which were group of 56 -60, 61 -65, 66 -70 and more than 70. Analysis of variance (ANOVA) was used for comparing difference between menopausal age and menstruation span. Multiple factor regressions was used to analyze the relationship between menarche age, parity and menopausal age and menstruation span. Results (1) Spontaneous menopausal age: the minimum was 29 years old, the maximum was 61 years old, and the mean age was (50.6 ±3.7)years old. The mean spontaneous menopause age were (50.9 ± 3.4), ( 50.7 ± 3.7 ), (50.0 ± 4.1 ), (49.6 ±4.0) years in groups of 56 -60, 61 -65, 66 -70 and more than 70 years. With the increasing age range in four groups, the increasing trends of menopausal age were observed, which the difference of 1.36 year was shown between groups of 56 - 60 and more than 70 years. (2) Menstruation span: the mean of menstruation span was (34.3 ± 4.1 ) years, which the minimal age of 12 years and maximal age of 48 years were recorded. (34.6 ± 3.8), (34.3 ± 4.1 ), (33.9 ± 4.6), (33.2 ± 4. 5) were observed in groups of 56 - 60,61 -65, 66 -70 and more than 70 years. With the increasing age range in four groups, the increasing trends of menstruation span were observed, which the difference of 1.41 year was shown between groups of 56 –60 and more than 70 years. (3)The impact of menarche age on menopausal age and menstruation span: there was no correlation between menarche age and menopausal age ( r = 0.02); however, menstruation span was found to be negatively correlated with the menarche age ( r = - 0.43 ). (4) The impact of parity on menopausal age and menstruation span: the mean menopausal age of women who had 1 -2 deliveries was significantly higher than those had no delivery or more than 3 deliveries ( P < 0.05 ). However, there was no difference in menopausal age between women with 1 and 2 deliveries or between women without delivery and more than 3 deliveries (P > 0.05). Menstruation span of women with 1 delivery was significantly longer that those with more than 1 delivery( P < 0.05 ), similarly, women with 2 deliveries had longer menstruation span than women without delivery or more than 3 deliveries(P < 0.05 ). There were no difference in menstruation span between women with more than 3 deliveries and without delivery ( P >0.05 ). (5) Multifactor regression analysis for menstruation span: menarche age was correlated with menstruation span negatively ( r = - 0.97,P <0.001 ). There was significantly different menstruation span between group of 61 -65, 66 -70 or more than 70 years and group of 56-60 (r= -0. 18, P=0.020; r= -0.78,P <0.001 and r= - 1.23,P<0.001). Menstruation span in women with 1 -2 deliveries was significantly longer than that of women without delivery or more than 3 deliveries. (6)Multifactor logistic analysis of menopausal age: there was no association between menarche age and menopausal age, however, significant differences were found in mean menopausal age between different groups, which show that menopausal age of group 56 - 60 years was significant higher than the other groups, including age-group 61 -65 years ,66 -70 years and over 70 years ( r = - 0.18, P = 0.020; r = - 0.78,P < 0.001; r = - 1.23, P < 0.001 ). Menopausal age in women with 1 - 2 deliveries was significantly higher than those of women without delivery or with more than 3 deliveries,however, no difference between women with 1 and 2 deliveries or between women without deliveries and more than 3 deliveries was observed. Conclusion (1) Menopausal age and menstruation span exhibited increasing trends in Pudong district of Shanghai. (2) Menarche age and parity were the important factors influencing menopausal age and menstruation span. (3) With younger age of menarche, the menstruation span become longer. (4) Deliveries of 1 -2 times can significantly delay the menopause and prolong menstruation span, however, the multiple deliveries ( ≥ 3 times) had no significant impact on menopausal age and menstruation span.     

上海市浦东新区妇女绝经年龄及行经年限调查与影响因素分析

Objective To investigate natural spontaneous menopausal age , menstruation span and their relationship with menarche age and parity in Pudong district of Shanghai. Methods From Jan 2007 to Jul 2008, 15 083 spontaneous menopause women undergoing cervical cancer screening were enrolled in this study. The questionnaire included menarche age, parity, spontaneous menopausal age and menstruation span. Those women were divided into four groups based on age, which were group of 56 -60, 61 -65, 66 -70 and more than 70. Analysis of variance (ANOVA) was used for comparing difference between menopausal age and menstruation span. Multiple factor regressions was used to analyze the relationship between menarche age, parity and menopausal age and menstruation span. Results (1) Spontaneous menopausal age: the minimum was 29 years old, the maximum was 61 years old, and the mean age was (50.6 ±3.7)years old. The mean spontaneous menopause age were (50.9 ± 3.4), ( 50.7 ± 3.7 ), (50.0 ± 4.1 ), (49.6 ±4.0) years in groups of 56 -60, 61 -65, 66 -70 and more than 70 years. With the increasing age range in four groups, the increasing trends of menopausal age were observed, which the difference of 1.36 year was shown between groups of 56 - 60 and more than 70 years. (2) Menstruation span: the mean of menstruation span was (34.3 ± 4.1 ) years, which the minimal age of 12 years and maximal age of 48 years were recorded. (34.6 ± 3.8), (34.3 ± 4.1 ), (33.9 ± 4.6), (33.2 ± 4. 5) were observed in groups of 56 - 60,61 -65, 66 -70 and more than 70 years. With the increasing age range in four groups, the increasing trends of menstruation span were observed, which the difference of 1.41 year was shown between groups of 56 –60 and more than 70 years. (3)The impact of menarche age on menopausal age and menstruation span: there was no correlation between menarche age and menopausal age ( r = 0.02); however, menstruation span was found to be negatively correlated with the menarche age ( r = - 0.43 ). (4) The impact of parity on menopausal age and menstruation span: the mean menopausal age of women who had 1 -2 deliveries was significantly higher than those had no delivery or more than 3 deliveries ( P < 0.05 ). However, there was no difference in menopausal age between women with 1 and 2 deliveries or between women without delivery and more than 3 deliveries (P > 0.05). Menstruation span of women with 1 delivery was significantly longer that those with more than 1 delivery( P < 0.05 ), similarly, women with 2 deliveries had longer menstruation span than women without delivery or more than 3 deliveries(P < 0.05 ). There were no difference in menstruation span between women with more than 3 deliveries and without delivery ( P >0.05 ). (5) Multifactor regression analysis for menstruation span: menarche age was correlated with menstruation span negatively ( r = - 0.97,P <0.001 ). There was significantly different menstruation span between group of 61 -65, 66 -70 or more than 70 years and group of 56-60 (r= -0. 18, P=0.020; r= -0.78,P <0.001 and r= - 1.23,P<0.001). Menstruation span in women with 1 -2 deliveries was significantly longer than that of women without delivery or more than 3 deliveries. (6)Multifactor logistic analysis of menopausal age: there was no association between menarche age and menopausal age, however, significant differences were found in mean menopausal age between different groups, which show that menopausal age of group 56 - 60 years was significant higher than the other groups, including age-group 61 -65 years ,66 -70 years and over 70 years ( r = - 0.18, P = 0.020; r = - 0.78,P < 0.001; r = - 1.23, P < 0.001 ). Menopausal age in women with 1 - 2 deliveries was significantly higher than those of women without delivery or with more than 3 deliveries,however, no difference between women with 1 and 2 deliveries or between women without deliveries and more than 3 deliveries was observed. Conclusion (1) Menopausal age and menstruation span exhibited increasing trends in Pudong district of Shanghai. (2) Menarche age and parity were the important factors influencing menopausal age and menstruation span. (3) With younger age of menarche, the menstruation span become longer. (4) Deliveries of 1 -2 times can significantly delay the menopause and prolong menstruation span, however, the multiple deliveries ( ≥ 3 times) had no significant impact on menopausal age and menstruation span.     

年龄、绝经年限与骨代谢指标相关性研究

目的 :探讨妇女不同年龄段、绝经年限、初潮年龄的骨代谢指标的变化。方法 :随机选择年龄 2 0～ 75岁的妇女 2 10例 ,测定血清钙 (Ca)、磷 (P)、碱性磷酸酶 (ALP)、性激素 ,尿钙 /肌酐 (Ca/Cr)值。结果 :骨代谢指标与年龄、绝经年限、初潮年龄均呈正相关 ,40岁以上的妇女的骨代谢指标明显高于 40岁以下的妇女 (P <0 0 5 ) ;初潮年龄在 18岁以上的妇女骨代谢指标明显增高 (P <0 0 5 ) ;绝经后E2 水平较绝经前降低 (P <0 0 5 ) ,但不同绝经年限间差异无显著性 (P >0 0 5 ) ;绝经后骨代谢指标较绝经前增高 (P <0 0 5 ) ,尤其在绝经后 10年以上增高更明显。结论 :妇女在围绝经早期出现骨转换率增高 ,可能与雌激素下降有关 ,因此对围绝经早期妇女 ,尤其是初潮年龄晚者 ,应进行骨代谢指标测定 ,筛查并及时预防骨质疏松症     

Risk factors for postmenopausal osteoporosis: anthropometric measurements,age, age at menopause and the time elapsed after menopause onset

Objectives.?The aim of this study was to determine, how much the anthropometric measurements and age affect the femur and vertebra T-scores by using correlation and regression analysis in postmenopausal women.

Methods.?Data of 540 healthy postmenopausal women were included in this analysis. Bone mineral density was determined by dual energy X-ray absorptiometry (DXA). The data of the patients related to height, weight, age, age at menopause were obtained from records, and body mass index (BMI) was calculated (BMI = W (kg)/H(m²)). Statistical analyses were performed with SPSS 15.0 for Windows (SPSS, Chicago, IL).

Results.?Mean age and standard deviation of 540 postmenopausal women was 59.3 ± 8.4 years. The correlation coefficients among femur, vertebra T-scores, weight, the time elapsed after the menopause onset, age, BMI and height were found as follows, from higher to lower values with 0.465, 0.453, 0.411, 0.382, 0.232, respectively, and were statistically significant (p < 0.001).

Conclusions.?We determined the effects of the anthropometric measurements on osteoporosis from higher to lower influence as follows: weight, menopause age, age, BMI and height. Weight and menopause age of the patients were the major determinants for osteoporosis.     

绝经后不同时期骨丢失的初步探讨

目的探讨妇女绝经后早期与晚期的骨丢失特点及骨转换规律,评价生化指标对预测骨丢失的意义。方法对３２例绝经１～３年（绝经早期组）妇女及３３例绝经１５～３０年（绝经晚期组）妇女,在试验初始（０个月）、６、１２个月分别测定骨密度、血总碱性磷酸酶、骨钙素、骨碱性磷酸酶、尿钙／尿肌酐、尿吡啶啉。结果绝经早期组妇女６、１２个月脊柱平均骨丢失率为１．３％、２．６％;股骨部位骨丢失不明显;腰椎骨丢失率＞３％（快速丢失）的１５例,＜３％（慢速丢失）的１７例。绝经晚期组６、１２个月股骨颈,Ｗａｒｄ＇ｓ三角骨丢失率分别为１．３％、１．９％,５．３％、４．６％,腰椎骨丢失不明显。两组尿吡啶啉随时间呈上升趋势,血骨钙素、骨碱性磷酸酶水平随时间变化趋势相似。生化指标与腰椎骨丢失率之间无相关性。结论绝经早期妇女骨丢失以腰椎部位敏感,快速与慢速骨丢失者约各占一半。绝经晚期妇女骨丢失以股骨颈、Ｗａｒｄ＇ｓ三角区显著,以慢速骨丢失者为主。两组妇女骨转换均增强     

孕激素对绝经后妇女骨质代谢的影响

选取１９８７年１月至１９９０年１２月，因子宫肌瘤行全子宫、双例附件除的手术后病人２６例及自然绝经无内科合并症女女４例，随机分为Ｉ组和Ⅱ组，每组１５。Ｉ组服宫黄体酮１０ｍｇ，每日２次，连续３个月；Ⅱ组口服安宫黄体酮１０ｍｇ，每日２次；口服尼尔雌醇５ｍｇ，每月１次，连续３个月。     

不同方案联合用药治疗围绝经期及绝经后期骨质疏松症的疗效观察

目的 探讨不同方案联合用药治疗围绝经期及绝经后期骨质疏松症(OP)的疗效.方法 选择2008年7月至2009年12月在温州医学院附属第二医院妇科门诊就诊的伴有骨量减少或OP的围绝经期及绝经后期妇女109例,随机分为3组,A组36例,口服氨基酸螯合钙1000 mg/d+阿法骨化醇0.25μg/bid;B组40例,口服氨基酸螯合钙1000 mg/d+阿法骨化醇0.25 μg/bid+替勃龙1.25 mg/d;C组33例,口服氨基酸螯合钙1000 mg/d+阿法骨化醇0.25μg/bid+阿仑膦酸钠70 mg(每周1次).3组妇女均连续服药48周.治疗前、后采用双能X线吸收法测定腰锥第1～4节(L1-4)及左股骨骨密度(BMD);同时采用酶联免疫吸附试验检测血清骨碱性磷酸酶(BALP)、羟基末端肽(CTX)、25-羟维生素D3[25(OH)D3]水平.结果 109例中共有7例(6.4%,7/109)因自动停药、副反应较重不能忍受或失去联系而退出,其中A组2例(失去联系)、B组3例(自动停药)、C组2例(上腹部隐痛不适,烧灼感),退出病例未纳入统计.(1)疼痛症状改善:3组妇女治疗48周后,临床疼痛等症状均明显改善,改善率分别为85%(29/34)、92%(34/37)和94%(29/31);(2)BMD:3组妇女治疗后BMD均明显提高,治疗前A、B、C组L1-4BMD分别为(0.88±0.15)、(0.89±0.18)、(0.87±0.10)g/cm2;治疗后分别为(0.90±0.01)、(0.93±0.09)、(0.91±0.11)g/cm2;治疗前A、B、C组左股骨BMD分别为(0.87±0.07)、(0.87±0.07)、(0.85±0.12)g/cm2;治疗后分别为(0.90±0.03)、(0.91±0.08)、(0.89±0.12)g/cm2.B、C组与A组比较,差异均有统计学意义(P<0.01),而B、C两组间比较,差异无统计学意义(P>0.05);(3)骨代谢指标:治疗前A、B、C组BALP分别为(26±6)、(26±9)、(28±7)μg/L,治疗后分别为(22±5)、(20±9)、(22±8)μg/L,3组治疗后均较治疗前显著下降,差异有统计学意义(P<0.05);治疗前A、B、C组CTX分别为(0.85±0.20)、(0.84±0.47)和(0.88±0.11)ng/L,治疗后分别为(0.81 ±0.19)、(0.77±0.33)和(0.82±0.14)ng/L,3组治疗后均较治疗前显著下降,差异有统计学意义(P<0.05).结论 3种联合用药方案均可用于OP的治疗,可降低骨转换、增加BMD、减少骨吸收;A组方案可作为基础治疗,B、C组方案较基础治疗效果好.     

尼尔雌醇对去卵巢大鼠胫骨作用的研究

目的 了解卵巢切除（ＯＶＸ）大鼠胫骨对雌激素治疗的反应。方法 将３３只雌性大鼠随机分成３组,每组１１只：ＯＶＸ组、对照组和治疗组。对ＯＶＸ组与治疗组大鼠行ＯＶＸ手术,建立骨质疏松动物模型,治疗组于ＯＶＸ术后１个月予尼尔柴醇喂养,药物喂养３个月后处死,用骨形态计量学方法检测ＯＶＸ大鼠左后肢胫骨干骺端对纪尔雌醇治疗的反应。结果 ＯＶＸ组大鼠骨小梁体积小、平均骨小梁宽度、平均骨小梁密度和皮质骨平均厚度（     

结合雌激素联合方案连续应用防治绝经早期妇女骨量丢失的观察

目的　探讨两种剂量结合雌激素 (CEE)对绝经早期妇女骨丢失的影响及副作用。方法将 2 36例绝经妇女分为 3组 ,A组每日口服CEE 0 62 5mg+醋甲羟孕酮 (MPA) 2mg +钙剂 (Ca D) 1片(含元素钙 60 0mg) ;B组每日口服CEE 0 3mg +MPA 2mg +Ca D 1片 ;C组每日仅服Ca D 1片 ,连续用药 2年。于治疗前、治疗 1 2及 2 4个月测量第 2～ 4腰椎 (L2～ 4 )的骨密度 (BMD) ,记录每月阴道出血情况。结果　A组治疗前、治疗 1 2及 2 4个月 ,L2～ 4 BMD分别为 (1 0 62± 1 4 1 )、(1 0 86± 1 4 5)及 (1 1 0 1±1 34)mg/cm2 ,治疗前后比较 ,差异均有极显著性 (P <0 0 0 1 ) ;B组分别为 (1 0 81± 1 35)、(1 1 1 1± 1 68)及(1 0 90± 1 50 )mg/cm2 ,治疗 1 2个月时与治疗前比较 ,差异有显著性 (P <0 0 5) ,治疗 2 4个月时与治疗前比较 ,差异无显著性 (P >0 0 5) ;C组分别为 (1 0 70± 1 1 9)、(1 0 65± 1 34)及 (1 0 53± 1 30 )mg/cm2 ,治疗前后比较 ,差异均无显著性 (P >0 0 5)。治疗前后BMD的变化 ,A与C组、B与C组之间差异均有显著性 (P <0 0 0 1 ,<0 0 5) ;A与B组治疗 1 2个月时的BMD比较 ,差异无显著性 (P >0 0 5) ,2 4个月时比较 ,差异有极显著性 (P <0 0 1 )。各组子宫内膜均无不典型增生。A、B组出血率 ,治