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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。
Objectives Medroxyprogesterone acetate injection contraceptives are widely used because of their simple and efficient use, but they can reduce the bone mineral density and increase the risk of osteoporosis. This study was to observe the effects of DMPA for 24 months in women aged 19-24 years, Similar to non-hormonal contraceptive women, to assess the impact of DMPA on lumbar spine and femoral neck BMD. Methods Eighty-seven women aged 19-24 years old were enrolled in this study. DMPA was applied for 24 months. Eighty-three women with similar age were enrolled in the study. Non-hormonal contraception was used as control group. BMD of lumbar and femoral neck was measured by dual-energy X-ray absorptiometry For 24 months. The changes of BMD in lumbar and femoral neck were compared between the two groups. Results At 24 months, the BMD of lumbar and femoral neck was decreased by 2.67% and 2.71% respectively compared with the baseline value, but there was no significant difference (P = 0.080 and P = 0.076). The BMD of lumbar spine and femoral neck in non-hormonal contraceptive control group increased by 1.24% and 1.30% respectively, with no significant difference from the baseline (P = 0.436 and P = 0.373). In the first year of treatment, there was no significant difference in average BMD between lumbar and femoral neck between the DMPA group and the control group (P = 0.153 and P = 0.140), but there was significant difference between the two groups in the second year (P = 0.012 and P = 0.008). Conclusion Short-term use of DMPA (<12 months) in young women has no significant adverse effect on lumbar spine and femoral neck BMD, but long-term use adversely affects BMD.