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[绝经前卵巢切除术对骨矿物质含量的影响评估]

[Evaluation of the effect of premenopausal oophorectomy on bone mineral content].

作者信息

Ueno N, Kato Y, Masuda R, Amano K

机构信息

Department of Obstetrics and Gynecology, Yokosuka Kyosai Hospital, Kanagawa.

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1989 Mar;41(3):308-12.

PMID:2786541
Abstract

The effects of premenopausal oophorectomy on bone mineral content (BMC) and serum parameters of bone metabolism, ie E2, PTH, Ca, P, ALP, BGP, 1-25(OH)2D3 were studied. The BMC of the spongiosum of L-3 vertebral body was calculated by means of computed tomography which was utilized in conjunction with a calibrated phantom containing a set of reference densities (CaCO3). The BMC tended to decrease markedly in the late 40s (r = -0.669, p less than 0.01) and a 38% decrease was found among the postmenopausal group (age 50-60) in comparison with the premenopausal group (age 40-49) (206.9 +/- 38.0 vs 128.5 +/- 32.7 mg/cm3, p less than 0.005). In cases of premenopausal bilateral oophorectomy (mean age 42.5) the BMC was found to decrease significantly about 2 years after the operation (150.0 +/- 25.2 mg/cm3, p less than 0.005), while no significant difference was found between the controls (mean age 43.5) and unilateral oophorectomized cases (mean age 40.3). Findings that indicated a decrease in E2, a significant increase in BGP and ALP, and a tendency for PTH to decrease were noted among bilateral oophorectomized cases and this may indicate accelerated osteogenesis. It was suggested that premenopausal bilateral oophorectomized cases are in danger of developing severe osteoporosis and are candidates for rigorous preventive treatment.

摘要

研究了绝经前卵巢切除术对骨矿物质含量(BMC)及骨代谢血清参数,即雌二醇(E2)、甲状旁腺激素(PTH)、钙(Ca)、磷(P)、碱性磷酸酶(ALP)、骨钙素(BGP)、1,25-二羟维生素D3的影响。通过计算机断层扫描计算L-3椎体松质骨的BMC,该扫描与包含一组参考密度(碳酸钙)的校准体模一起使用。BMC在40多岁后期有明显下降趋势(r = -0.669,p < 0.01),绝经后组(年龄50 - 60岁)与绝经前组(年龄40 - 49岁)相比,BMC下降了38%(206.9 ± 38.0 vs 128.5 ± 32.7 mg/cm³,p < 0.005)。在绝经前双侧卵巢切除的病例(平均年龄42.5岁)中,术后约2年发现BMC显著下降(150.0 ± 25.2 mg/cm³,p < 0.005),而对照组(平均年龄43.5岁)和单侧卵巢切除病例(平均年龄40.3岁)之间未发现显著差异。在双侧卵巢切除病例中发现E2下降、BGP和ALP显著升高以及PTH有下降趋势,这可能表明成骨加速。提示绝经前双侧卵巢切除的病例有发生严重骨质疏松症的危险,是严格预防性治疗的候选对象。

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