Ryde S J, Bowen-Simpkins K, Bowen-Simpkins P, Evans W D, Morgan W D, Compston J E
Department of Medical Physics, Singleton Hospital, Swansea.
Clin Endocrinol (Oxf). 1994 Jan;40(1):33-8. doi: 10.1111/j.1365-2265.1994.tb02440.x.
Although there is evidence from cross-sectional studies that percutaneous oestrogen administration protects against menopausal bone loss, few longitudinal data are available. We have examined the effect of 3 years' treatment with percutaneous oestradiol on total body calcium, spinal trabecular bone mineral density and radial bone mineral content in post-menopausal women.
Twenty-nine post-menopausal women, aged 37-55 years, who had undergone hysterectomy and had experienced the onset of menopausal symptoms within the previous 2 years, were studied before and for 3 years during hormone replacement with oestradiol implants, given at approximately 6-monthly intervals.
Total body calcium was measured by prompt gamma neutron activation analysis, spinal trabecular bone mineral density by quantitative computed tomography and radial bone mineral content by single-photon absorptiometry.
There was a significant increase in the mean total body calcium, spinal trabecular bone mineral density and radial bone mineral content over the 3 years of the study. The mean (+/- SEM) percentage change per annum was +2.4% (+/- 0.8) for total body calcium (P < 0.01), +3.3% (+/- 0.6) for spinal trabecular bone mineral density (P < 0.001) and +1.2% (+/- 0.6) for radial bone mineral content (P < 0.05).
Percutaneous oestradiol replacement therapy prevents menopausal bone loss and is associated with a sustained and significant increase in total body calcium, spinal trabecular bone mineral density and radial bone mineral content over a 3-year treatment period. Oestradiol implants thus have skeletal effects comparable to those of oral or transdermal oestrogens.
尽管横断面研究有证据表明经皮给予雌激素可预防绝经后骨质流失，但纵向数据却很少。我们研究了经皮雌二醇治疗3年对绝经后女性全身钙、脊柱小梁骨矿物质密度和桡骨骨矿物质含量的影响。
29名年龄在37 - 55岁之间的绝经后女性，她们已接受子宫切除术，且在过去2年内开始出现绝经症状，在接受雌二醇植入物激素替代治疗前及治疗3年期间进行研究，植入物大约每6个月给予一次。
全身钙通过瞬发γ中子活化分析测量，脊柱小梁骨矿物质密度通过定量计算机断层扫描测量，桡骨骨矿物质含量通过单光子吸收法测量。
在研究的3年中，平均全身钙、脊柱小梁骨矿物质密度和桡骨骨矿物质含量均有显著增加。每年平均（±标准误）变化百分比为：全身钙+2.4%（±0.8）（P < 0.01），脊柱小梁骨矿物质密度+3.3%（±0.6）（P < 0.001），桡骨骨矿物质含量+1.2%（±0.6）（P < 0.05）。
经皮雌二醇替代疗法可预防绝经后骨质流失，并且在3年治疗期内与全身钙、脊柱小梁骨矿物质密度和桡骨骨矿物质含量的持续显著增加相关。因此，雌二醇植入物对骨骼的作用与口服或经皮雌激素相当。
