卵巢切除对绝经前妇女骨代谢的影响

目的：观察卵巢切除对绝经前妇女骨代谢的影响。方法：检测绝经前因各种原因行卵巢切除术的74例患者的血清骨碱性磷酸酶及血清抗酒石酸酸性磷酸酶5b,其中单侧卵巢切除者48例（A组）,双侧卵巢切除者26例（B组）,并与未停经且无卵巢手术史的30例健康妇女（C组）作对照。结果：3组间BALP水平的差异具有统计学意义（F=10.08,P=0.0032）;A组患者的BALP水平高于B组（q=4.12,P=0.0073）,而低于C组（q=2.97,P=0.038）,B组患者的BALP水平低于C组（q=6.34,P=0.0030）。3组间TRACP5b水平的差异具有统计学意义（F=13.79,P=0.0001）;A组患者的TRACP5b水平低于B组（q=4.20,P=0.0072）,而高于C组（q=4.15,P=0.0073）,B组患者的TRACP5b水平高于C组（q=7.51,P=0.0024）。结论：绝经前因各种疾病行卵巢切除后,成骨细胞活性降低,骨形成减少;破骨细胞活性增强,骨吸收加快。应在术后早期检测骨代谢生化指标,为防治骨质疏松症提供依据。

Clinical study on effect of ovariectomy on bone metabolism of women in premenopause

Objective:To observe the effect of ovariectomy on bone metabolism of women in premenopause.Methods:74 patients who were oophorectomized for various diseases before menopause were chosen to be studied. Among these patients,48 cases who were unilateral oophorectomized were divided into group A and 26 cases who were bilateral oophorectomized were divided into group B. At the same time,30 normal women were chosen for control. Serum levels of bone alkaline phosphatase(BALP) and tartrate-resistant acid phosphatase 5b(TRACP5b) in all these women were detected.Results:There were statistical differences of the serum levels of BALP among the three groups(F=10.08,P=0.003 2). The serum levels of BALP in group A were higher than those in group B(q=4.12, P=0.007 3) and were lower than those in group C(q=2.97, P=0.038),while the serum levels of BALP in group B were lower than those in group C(q=6.34, P=0.003 0). There were statistical differences of the serum levels of TRACP5b among the three groups(F=13.79,P=0.000 1). The serum levels of TRACP5b in group A were lower than those in group B(q=4.20, P=0.007 2) and were higher than those in group C(q=4.15, P=0.007 3),while the serum levels of TRACP5b in group B were higher than those in group C(q=7.51, P=0.002 4).Conclusion:Ovariectomy before menopause leads to a decrease in the activity of osteoblast and an increase in the activity of osteoclast.As a result,the bone formation decreases and the bone resorption increases.Therefore, the biochemical parameters of bone metabolism should be detected early after ovariectomy in order to provide proof to prevent osteoporosis.