联合低剂量激素疗法与替勃龙预防骨质流失的比较。

Comparison of combined low-dose hormone therapy vs. tibolone in the prevention of bone loss.

作者信息

Kalder M, Kyvernitakis I, Hars O, Kauka A, Hadji P

机构信息

a Department of Obstetrics and Gynecology , Philipps University of Marburg , Germany ;

b Statistical Institute , Berlin , Germany ;

出版信息

Climacteric. 2016 Oct;19(5):471-7. doi: 10.1080/13697137.2016.1198313. Epub 2016 Jun 27.

DOI:10.1080/13697137.2016.1198313

PMID:27345158

Abstract

OBJECTIVES

To compare the effects on bone mineral density (BMD) measured by dual-energy X-ray absorptiometry at the lumbar spine, the femoral neck and the total hip following 2 years of treatment with a low-dose combined hormone therapy (HT) comprised of 1 mg estradiol and 0.5 mg norethisterone acetate (E2/NETA) versus 2.5 mg tibolone in postmenopausal women. Additionally, quantitative ultrasonometry (QUS) of the os calcaneus and of the phalanges was performed.

METHODS

Changes in BMD, QUS and side-effects were assessed at baseline, 6, 12 and 24 months in 50 postmenopausal women who received either E2/NETA (n = 26) or tibolone (n = 24) for 2 years.

RESULTS

Compared to women on tibolone, women receiving E2/NETA showed a significant increase in BMD from baseline to 12 and 24 months at the lumbar spine (3.07%, 3.86%; p < 0.01 vs. 1.13%, 2.23%; p < 0.05), and at the total hip (1.33%, 1.69%; p < 0.01 vs. 0.76%, 0.70%) and at the femoral neck from baseline to 24 months (1.10%; p < 0.05). QUS indices only showed a significant change with the ultrasound bone profile index with E2/NETA at 6 months (-2.32%; p < 0.001).

CONCLUSIONS

Low-dose E2/NETA showed a significantly higher increase in BMD compared to tibolone. QUS measurement was not considered to comprise beneficial effects in monitoring drug-induced bone changes.

摘要

目的

比较在绝经后女性中，接受为期2年的由1毫克雌二醇和0.5毫克醋酸炔诺酮组成的低剂量联合激素疗法（HT）与2.5毫克替勃龙治疗后，通过双能X线吸收法测量的腰椎、股骨颈和全髋部骨密度（BMD）的变化。此外，还对跟骨和指骨进行了定量超声检查（QUS）。

方法

对50名接受E2/NETA（n = 26）或替勃龙（n = 24）治疗2年的绝经后女性，在基线、6个月、12个月和24个月时评估BMD、QUS的变化以及副作用。

结果

与接受替勃龙治疗的女性相比，接受E2/NETA治疗的女性在腰椎从基线到12个月和24个月时BMD显著增加（分别为3.07%，3.86%；与1.13%，2.23%相比，p < 0.01；p < 0.05），在全髋部从基线到24个月时BMD显著增加（分别为1.33%，1.69%；与0.76%，0.70%相比，p < 0.01），在股骨颈从基线到24个月时BMD显著增加（1.10%；p < 0.05）。QUS指标仅在6个月时使用E2/NETA治疗时，超声骨轮廓指数有显著变化（-2.32%；p < 0.001）。