手术绝经后妇女结合雌激素替代治疗的临床观察

目的探讨手术绝经后妇女用结合雌激素替代治疗的必要性.方法选取2年内行子宫加双卵巢切除者20例(双侧组),行子宫加单侧卵巢切除者21例(单侧组).口服结合雌激素0.625 mg/d,每月连续服用28d,共服用6个月.观察治疗前后Kuppeman评分、血FSH、LH、E2骨密度(BMD)及骨生化指标的变化.结果两组治疗后更年期症状明显改善(P＜0.001);两组术后血FSH、LH升高,双侧组较单侧组高(P＜0.01,P＜0.05);E2下降,双侧组较单侧组低(P＜0.05).治疗前、后两组FSH、LH、E2有明显差异(P＜0.01-P＜0.001).两组治疗前骨密度(BMD)变化有差异(P＜0.05),治疗后两组BMD无明显变化(P＞0.05);血ALP治疗前、后无明显变化(P＞0.05);尿钙/肌酐、尿羟脯氨酸/肌肝均有下降(P＜0.05).结论手术绝经后妇女用雌激素替代治疗能有效地改善更年期症状,减缓骨吸收速度,减少骨质丢失,防治骨质疏松.

Clinic Evaluation of Conjugated Estrogen for Postoperative Menopausal Women

Objective: The aim of this study is to discuss the importance of hormone replace therapy for postoperative menopausal women. Methods: 20 women undergoing hysterectomy and bilateral oophorectomy (bilateral group) and 21 women undergoing hysterectomy and one - side oophorectomy (one - side group) within two years were included. Conjugated estrogen at an oral dose of 0. 625/day was assigned to each participant for 6 months. The results were evaluated by comparing Kupperman Score, serum FSH, LH. E2, bone mass density (BMD) of pre and post medication. Results: The climacteric symptoms alleviated significantly (P < 0. 001) in both groups after medication. Before intervention, either group had high levels of serum FSH, LH and a low level of E2, while the bilateral group presenting a significantly more obvious change when compared with the one - side group. After six months medication, the serum FSH, LH levels were significantly lowered, while the serum E2 elevated (P < 0. 01 - P < 0. 001 ). The BMD changed significantly compared with pre - intervention in both groups and its level remains une3dlin3e. There was no significantly difference in the value of serum ALP. The values of urinary calcium/creatinine ratio and urinary hydroxproline /creatinine lowered (P < 0. 01 ). Conclusion: Hormone replacement therapy may effectively alleviate climacteric symptoms, slowdown bone resorption and reduce bone loss,therefore may prevent osteoposis in postoperative menopausal women.