绝经前全子宫切除保留卵巢对妇女骨代谢及骨密度的影响

目的 :追踪观察绝经前妇女全子宫切除保留卵巢对远期骨代谢及骨密度的影响。方法 :对比观察绝经前行全子宫切除保留单侧卵巢 4 8例、全子宫切除保留双侧卵巢 15例和正常妇女 30例的血清钙 (Ca)、血清磷 (P)、血清碱性磷酸酶 (AKP)、血清骨钙素(BGP)、空腹尿Ca Cr及尿HYP Cr值、骨密度值的变化和差异。结果 :全子宫切除保留单侧卵巢组血AKP值、BGP值、空腹尿Ca Cr和尿HYP Cr均显著高于对照组 (P <0 0 5 ) ,而骨密度值则显著低于对照组 (P <0 0 5 )。保留双侧卵巢组尿HYP Cr显著高于对照组 (P <0 0 5 )。结论 :子宫全切除保留单侧卵巢者远期骨转换加快 ,导致骨丢失及骨密度下降 ,双侧卵巢保留者骨吸收亦加快 ,但骨密度无下降

Effects of premenopausal hysterectomy with ovaries conservation on bone metabolism and bone density

Objective:To observe the long term effects of premenopausal hysterectomy with one or two ovaries conservation on the bone metabolism and bone density.Methods:48 women who had premenopausal hysterectomy with one ovary conservation and 15 women who had premenopausal hysterectomy with two ovaries conservation were recruited.There were 30 normal women as control group who were randomly selected in the same area.All women were examined for serum calcium(Ca),phosphate(P),alkaline phosphatase(AKP),bone glaprotein(BGP),urinary Ca/Cr,urinary HYP /Cr and bone mineral density.Results: The levels of AKP,BGP,urinary Ca/Cr and urinary HYP /Cr in women with one ovary conservation were significantly higher than those of the control group(P<0 05),but the bone density was significantly lower than that of the control group(P<0.05).The level of urinary HYP /Cr in women with two ovaries conservation was significantly higher than that of the control group (P<0.05). Conclusions:The hysterectomized women with one ovary conservation may have the problem of increased bone turnover and bone loss and lower bone density.Although the women with two ovaries conservation also have an increased bone absorption,but the bone density is not decreased.