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为探讨长期缓释单孕激素对妇女骨代谢的影响,测定使用国产Ⅰ、Ⅱ型长效避孕皮下埋植剂和Norplant 3年以上妇女的骨密度及骨代谢指标。采用回顾、设对照组的研究方法,测定123例妇女骨密度(BMD)及其骨代谢指标血钙(Ca)、磷(P)、碱性磷酸酶(ALP)、骨钙素(BGP)、血清雌激素(E_2),尿钙(Ca)、尿肌肝(Cr)和尿羟脯氨酸(HYP)等。结果表明国产Ⅰ、Ⅱ型和Norplant组妇女骨峰值形成期(30～40岁)使用皮埋剂的三组妇女平均E_2水平有不同程度降低,但均在正常低限水平内,与对照组间无差别。除对照组外三组妇女平均E_2水平与BMD之间不呈线性关系;Norplant组妇女BMD和Ca/Cr、HTP/Cr的变化说明骨吸收过程增强。使用国产Ⅰ、Ⅱ型皮埋剂和Norplant妇女3年后平均E_2水平在正常低水平上波动,未造成BMD的变化及其它骨代谢指标的明显变化;三组皮埋剂妇女骨峰值形成期(30～40岁),骨密度处于正常水平范围。长效LNG缓释皮埋剂对育龄妇女在骨代谢方面是安全的。
To investigate the effects of long-term sustained release of progestin on the bone metabolism in women, the bone mineral density and bone metabolic parameters of domestic women with type Ⅰ and Ⅱ long-acting contraceptive implants and norplant of 3 years or more were measured. A retrospective and control group study was conducted to determine the bone mineral density (BMD) and bone mineral density (Ca), phosphorus (P), alkaline phosphatase (ALP), osteocalcin (BGP) Serum estrogen (E2), urinary calcium (Ca), urinary muscle liver (Cr) and urinary hydroxyproline (HYP) and so on. The results showed that the average E_2 levels of the three groups of women with type Ⅰ, Ⅱ and Norplant in peak bone formation (30-40 years) in the bone formation group decreased to some extent, but were within the normal lower limit, No difference. There was no linear relationship between mean E2 level and BMD among three groups except control group. The changes of BMD, Ca / Cr and HTP / Cr in Norplant group showed that the bone resorption process was enhanced. The average level of E_2 fluctuated at normal low level after 3 years using domestic type Ⅰ and Ⅱ embedding agents and norplant women, which did not cause the change of BMD and other significant changes of bone metabolism indexes. The peak value of bone formation 30 to 40 years old), bone mineral density in the normal range. Long-acting LNG sustained-release skin embedding agent for women of childbearing age in bone metabolism is safe.