双侧卵巢切除对围绝经期妇女骨密度及身体成分的影响

目的探讨双侧卵巢切除术对围绝经期妇女骨密度、身体成分及性激素的影响。方法选择2009年1月1日—2009年12月31日期间在上海交通大学附属第六人民医院妇产科行双侧卵巢切除术的围绝经期患者33例（卵巢切除组）,以同期更年期门诊自然绝经妇女35例为对照组,采用美国GE-Lunar-Prodigy双能X线骨密度检测仪和化学发光法检测两组妇女在闭经6和12个月时的骨密度、脂肪含量、肌肉含量及性激素。结果两组妇女在闭经后6和12个月时,骨密度、脂肪含量、肌肉含量比较差异均无统计学意义（P〉0.05）。在闭经6个月时,卵巢切除组的雌二醇（E2）水平明显低于对照组[（14.79±22.17）U/Lvs（32.74±31.02U/L）]（P〈0.05）;闭经后12个月时,卵巢切除组的E2和卵泡刺激素（FSH）水平与对照组比较差异均有统计学意义[E2：（8.09±4.38）U/Lvs（25.92±3.53）U/L;FSH：（64.88±18.39）U/Lvs（40.69±31.63）U/L]（P〈0.05）。结论围绝经期双侧卵巢切除后12个月内主要表现为E2和FSH改变,而E2水平的降低对骨密度、脂肪含量以及肌肉含量的影响并未显现。

Impact of bilateral ovariectomy on bone mineral density and body composition in peri-menopausal women

Objective To investigate the impact of bilateral ovariectomy on bone mineral density, body composition and sex hormones levels in peri-menopausal women. Methods Thirty-three peri-menopausal women undergoing bilateral ovariectomy in Department of Obstetrics and Gynecology, The Sixth People's Hospital, Shanghai Jiaotong University from January 1st to December 31st 2009 were selected (ovariectomy group), and another 35 women of natual menopause visiting climacteric clinic during the same period were served as control group. Bone mineral density, fat mass, lean mass and sex hormone levels were measured by dual-energy X-ray absorptiometry and chemiluminescence method, respectively 6 and 12 months after menopause. Results Six and twelve months after menopause, there was no significant difference in bone mineral density, fat mass and lean mass between two groups (P>0.05). The estrodiol (E2) level in ovariectomy group was significantly lower than that in control group six months after menopause [（14.79±22.17）U/L vs （32.74±31.02 U/L）]（P<0.05）, and there were significant differences in E2 levels and follicle stimulating hormone (FSH) levels between two groups 12 months after menopause [E2：（8.09±4.38）U/L vs （25.92±3.53）U/L；FSH：（64.88±18.39）U/L vs （40.69±31.63）U/L]（P<0.05）. Conclusion Bilateral ovariectomy in peri-menopausal women may lead to significant changes of E2 and FSH levels within 12 months, while the decreased E2 level does not have significant impacts on bone mineral density, fat mass and lean mass.