激素补充治疗方案对围绝经期综合征患者体内性激素水平、子宫内膜厚度及骨密度的影响

目的研究激素补充治疗方案对围绝经期综合征患者体内性激素水平、子宫内膜厚度及骨密度的影响。方法前瞻性选取2017年5月至2019年8月柳州市妇幼保健院收治的100例围绝经期患者为对象,按照随机数字表法分为对照组和治疗组,各50例。对照组患者给予口服谷维素片对症治疗,治疗组患者给予口服芬吗通治疗,连续治疗28 d。观察比较2组患者治疗前、治疗28 d后体内卵泡刺激素(FSH)、雌二醇(E2)、孕酮(P)、黄体生成素(LH)水平、子宫内膜厚度、骨密度以及围绝经期症状变化情况。结果治疗前,2组患者性激素水平、子宫内膜厚度、骨密度和围绝经期症状评分比较,差异均无统计学意义(P>0.05);治疗28 d后,治疗组FSH、LH水平低于对照组(13.80±3.75)U/L vs.(20.21±3.95)U/L、(12.18±3.10)U/L vs.(14.50±3.50)U/L],E2、P水平高于对照组(124.30±16.40)nmol/L vs.(99.76±16.65)nmol/L、(3.90±0.40)pmol/L vs.(2.94±0.41)pmol/L],差异有统计学意义(P<0.05)。治疗组子宫内膜厚度较对照组厚(4.90±0.59)mm vs.(3.19±0.55)mm],差异有统计学意义(P<0.05)。治疗组脊椎、股骨颈密度高于对照组(1.20±0.18)g/cm^2 vs.(1.11±0.15)g/cm^2、(0.90±0.19)g/cm^2 vs.(1.04±0.15)g/cm^2],差异有统计学意义(P<0.05)。治疗组潮热出汗、抑郁、失眠、骨关节痛等症状评分低于对照组(3.10±0.86)分vs.(3.89±0.85)分、(0.69±0.42)分vs.(1.15±0.39)分、(1.98±0.77)分vs.(2.65±0.76)分、(0.75±0.73)分vs.(1.06±0.63)分],差异有统计学意义(P<0.05)。结论激素补充治疗方案可有效调节围绝经期综合征患者体内的性激素水平,缓解临床相关症状,增加子宫内膜厚度以及骨密度。

Effect of hormone replacement therapy on the sex hormones level,endometrial thickness and bone density in patients with perimenopausal syndrome

Objective To study the effects of hormone supplement therapy on the levels of sex hormones,endometrial thickness and bone density in patients with perimenopausal syndrome.Methods A total of 100 perimenopausal patients admitted to Liuzhou Maternal and Child Health Hospital from May 2017 to August 2019 were selected and divided into the control group(50 cases)and the treatment group(50 cases)according to the random number table method.The control group received symptomatic treatment with oryzanol tablets,and the treatment group was treated with oral femoston,28 days of treatment.The levels of follicle stimulating hormone(FSH),estradiol(E2),progesterone(P),luteinizing hormone(LH),endometrial thickness,bone density and perimenopausal symptoms in the two groups were compared and observed before and after 28 days of treatment.Results Before treatment,there was no significant difference in sex hormone levels,endometrial thickness,bone density,and perimenopausal symptom scores between the two groups(P>0.05).After 28 days of treatment,the FSH and LH levels of the treatment group were lower than those of the control group(13.80±3.75)U/L vs.(20.21±3.95)U/L,(12.18±3.10)U/L vs.(14.50±3.50)U/L],E2 and P levels were higher than the control group(124.30±16.40)nmol/L vs.(99.76±16.65)nmol/L,(3.90±0.40)pmol/L vs.(2.94±0.41)pmol/L],the differences were statistically significant(P<0.05).The endometrial thickness of the treatment group was thicker than that of the control group(4.90±0.59)mm vs.(3.19±0.55)mm],the difference was statistically significant(P<0.05).The density of spine and femoral neck in the treatment group was higher than that in the control group(1.20±0.18)g/cm^2 vs.(1.11±0.15)g/cm^2,(0.90±0.19)g/cm^2 vs.(1.04±0.15)g/cm^2],the differences were statistical significant(P<0.05).The scores of symptoms such as hot flashes,sweating,depression,insomnia,and bone and joint pain in the treatment group were lower than those in the control group(3.10±0.86)points vs.(3.89±0.85)points,(0.69±0.42)points vs.(1.15±0.39)points,(1.98±0.77)points vs.(2.65±0.76)points,(0.75±0.73)points vs.(1.06±0.63)points],the differences were statistically significant(P<0.05).Conclusion Hormone supplement therapy can effectively regulate the level of sex hormones in patients with perimenopausal syndrome,relieve clinical symptoms,and increase endometrial thickness and bone density.