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目的:研究长效醋酸甲孕酮避孕针(DMPA)对生育年龄妇女骨质代谢和卵巢功能影响。方法:选择自愿使用DMPA避孕者30例为实验组,采用避孕套避孕者30例为对照组。①测定两组血清碱性磷酸酶(AKP)、尿钙/肌酐(Ca/cr)、尿羟脯氨酸/肌酐(HYP/Cr);②测定非惯用臂桡尺骨骨密度(BMD)和桡尺骨超远端骨矿含量(BMC);③实验组于用药满一年时,对照组于月经周期第5天采用放免法测定血清性激素值;④实验组于首次用药当日及用药满一年,对照组于月经周期第5天B超监测卵泡发育状况;⑤实验组用药满一年时作阴道脱落细胞检查。结果:两组骨代谢生化指标及桡尺骨骨密度无显著性差异(P>0.05);实验组血清性激素值相当于正常育龄妇女卵泡早期水平,实验组有96.7％研究对象的卵巢内无卵泡或有小卵泡,最大卵泡直径≤1.5cm,卵泡发育状况相当于正常妇女卵泡早期水平,阴道脱落细胞检查显示雌激素水平无低落。结论:使用DMPA一年对骨质代谢无影响;DMPA使用者卵巢功能相当于正常育龄妇女卵泡早期水平。
Objective: To investigate the effect of long-acting megestrol acetate (DMPA) on bone metabolism and ovarian function in women of childbearing age. Methods: Thirty patients who volunteered to use DMPA contraceptives were selected as the experimental group and 30 cases of condoms contraceptives as the control group. ①The serum AKP, Ca / Cr, HYP / Cr were measured in both groups; ②The BMD and radius Ulnar ulnar distal bone mineral content (BMC); ③ experimental group at the age of one year, the control group on the 5th day of the menstrual cycle using radioimmunoassay serum hormone value; ④ experimental group on the first day of medication and medication for one year, The control group on the 5th day of the menstrual cycle B-monitoring of follicular development; ⑤ experimental group for one year when vaginal exfoliated cells for examination. Results: There was no significant difference in the biochemical markers of bone metabolism and radioulnar BMD between the two groups (P> 0.05). Serum sex hormone value in the experimental group was equivalent to that of the normal women of childbearing age. 96.7% of the subjects in the experimental group had no ovarian follicles or A small follicle, the largest follicle diameter ≤ 1.5cm, follicular development status equivalent to normal early follicular levels, vaginal exfoliated cells showed no estrogen levels. Conclusion: The use of DMPA has no effect on bone metabolism for one year. The ovarian function of DMPA users is equivalent to that of normal women of childbearing age.