【摘要】 目的了解年龄16~40岁低雌激素闭经患者骨密度情况及激素替代治疗(HRT)对其骨密度的影响。方法回顾性分析在北京协和医院妇科内分泌中心就诊的低雌激素闭经病例共86例,其中原发性闭经患者40例、继发性闭经患者46例;选择同期的社区志愿者中月经正常者52例作为对照组。采用双能X线法测量三组的骨密度。对18例原发性闭经患者及12例继发性闭经患者,进行HRT治疗,1年后复查骨密度。结果原发性闭经组和继发性闭经组与对照组比较,普遍存在腰椎和股骨骨密度显著性降低(P<0.01),Z值的均值示骨量减少,且原发性闭经组降低尤为明显。经HRT治疗1年后原发性闭经组骨密度增加(0.034±0.046)g/cm2,Z值增加(1.08±0.81);继发性闭经组骨密度增加(0.017±0.048)g/cm2,Z值增加(0.75±0.91),较治疗前均有显著性增加(P<0.05)。按卵泡刺激素(FSH)水平分组,高促性腺素组和正常(或)低促性腺素组的骨密度均显著低于对照组(P<0.01),但促性腺素分组之间骨密度无显著性差异。结论低雌激素闭经患者的骨密度均明显降低;HRT可增加骨密度,在原发性闭经组疗效尤为明显。更多还原

【Abstract】 Objective:To explore bone mineral density(BMD)level in patients aged 16-40years with low estrogen amenorrhea and effect of hormone replacement therapy(HRT)on their BMD level. Methods:Eighty six patients with low-estrogen amenorrhea,including 40patients with primary amenorrhea,46patients with secondary amenorrhea from gynecological endocrinology centers of Beijing Union Medical College Hospital were retrospectively analyzed.Fifty two volunteers with normal menstruation from a community were recruited as control group in the same period.The BMD level was measurement by dual-energy X-ray method.Eighteen patients with primary amenorrhea and 12patients with secondary amenorrhea were received HRT treatment,and repeated BMD examination one year later. Results:Patients with primary amenorrhea and secondary amenorrhea had lower BMD in lumbar spine and femur than controls(P<0.01).The mean of Z value showed osteopenia especially in patients with primary amenorrhea.After HRT treatment for 1year,the BMD level increased(0.034±0.046)g/cm2 in primary amenorrhea group,and the Z value increased(1.08±0.81).The BMD levels increased(0.017±0.048)g/cm2 and Z value increased(0.75±0.91)in secondary amenorrhea group.BMD level and Z value significantly increased than prior treatment in both groups(P<0.05).When the patients were grouped by follicle stimulating hormone(FSH)levels,the BMD level had no significant difference between the patients with high FSH levels and the patients with normal or low FSH levels.The BMD levels of all patients were significantly lower than control group(P<0.01).Conclusions:Patients with low estrogen amenorrhea have significantly lower bone mineral density.Hormone replacement therapy could increase bone density,especially for primary amenorrhea patient.更多还原