【摘要】 目的醋酸甲羟孕酮注射避孕药因使用简便、高效而广泛应用,但可降低骨矿物质密度,增加骨质疏松症风险,该文观察年龄19~24岁女性应用DMPA 24个月,与年龄类似非激素避孕妇女比较,评估DMPA对腰椎和股骨颈BMD的影响。方法选择87例年龄19~24岁女性应用DMPA 24个月,83例年龄相仿女性应用非激素避孕作为对照组,应用双能X线吸收法检测腰椎和股骨颈BMD,每12个月检测1次,连续24个月,比较两组腰椎和股骨颈BMD的改变。结果用药24个月,与基础值相比,腰椎和股骨颈BMD呈下降趋势,分别降低2.67%和2.71%,但无统计学差异(P=0.080和P=0.076)。而非激素避孕对照组腰椎和股骨颈BMD呈上升趋势,分别升高1.24%和1.30%,与基础值相比无统计学差异(P=0.436和P=0.373)。用药第1年,DMPA用药组与对照组相比,平均腰椎和股骨颈BMD值没有明显差异(P=0.153和P=0.140);但用药第2年,两组BMD值有明显差异(P=0.012和P=0.008)。结论年轻女性短期应用DMPA(<12个月)对腰椎和股骨颈BMD没有明显不利影响,但长期应用对BMD有不利影响。更多还原

【Abstract】 Objective:To evaluate the effect of depot medroxyprogesterone acetate(DMPA) contraceptive injection on bone mineral density(BMD) of lumbar vertebra and collum femoris by comparing 19-24-year-old women using DMPA for 24 months and the women in the same age group using non-hormonal contraceptives.Methods:Eighty-seven women aged 19-24 years old were treated with DMPA contraceptive injection for 24 months,eighty-three women in the same age group were treated with non-hormonal contraceptives.Dual-energy X-ray absorptiometry was used to detect BMD of lumbar vertebra and collum femoris every 12 months for two times; the changes of BMD of lumbar vertebra and collum femoris in the two groups were compared.Results:After 24 months of treatment,compared with the basal values,BMD of lumbar vertebra and collum femoris in DMPA group decreased by 2.67% and 2.71%,respectively,but there was no statistically significant difference(P = 0.080 and P = 0.076); BMD of lumbar vertebra and collum femoris in control group increased by 1.24%and 1.30%,respectively,but there was no statistically significant difference(P = 0.436 and P = 0.373).After 12 months,there was no statistically significant difference in BMD of lumbar vertebra and collum femoris between DMPA group and control group(P = 0.153 and P =0.140); but after 24 months,there were statistically significant differences between DMPA group and control group(P = 0.012 and P =0.008).Conclusion:Short-term application of DMPA(less than 12 months) has no obvious adverse impact on BMD of lumbar vertebra and collum femoris in young women,but long-term application has adverse effect.更多还原