绝经后妇女骨质疏松与颈动脉粥样硬化的相关性分析

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　　[摘要] 目的 探讨绝经期妇女骨质疏松与颈动脉粥样硬化斑块之间的相关性。为此类患者的综合诊治和预防寻找科学依据，进一步提高她们的健康水平和生活质量。 方法 绝经期妇女30例及对照组30例，均采用PHILIPS IU22彩色多普勒超声显像仪，选择频率7～12 MHz线阵专用血管探头，于前、侧颈部两个方向行连续纵、横切面探查,测定双侧颈总动脉、颈内动脉内膜-中层厚度（IMT），同时观察颈总动脉、颈内动脉斑块的数量，软硬斑块及其形态；对所有病例均检测骨钙素（BGP），并用双能X线测定骨形态发生蛋白（BMD），用SMAC技术检测碱性磷酸酶（ALP）、Ca、P含量。 结果 绝经期妇女BGP、BMD明显降低的同时，超声特点表现突出的为软斑块，突出于管腔内膜面，局部呈不同程度的低回声，硬斑块为局部回声增强，BGP、BMD与对照组比较差异有高度统计学意义（P < 0.01），ALP增高（P < 0.05）。Ca、P无变化。结论 绝经期妇女BGP、BMD降低的同时伴有颈动脉粥样硬化斑块形成，雌激素水平降低，与骨代谢、骨密度密切相关，与软、硬斑块的形态有关。因此检测BGP、BMD及彩色多普勒超声检查，对提高健康水平和生活质量有重要的临床意义。
　　[关键词] 绝经后妇女；骨钙素；骨密度；超声检查
　　[中图分类号] R681 [文献标识码] A [文章编号] 1673-7210（2012）08（a）-0061-03
　　Analysis of the correlation between osteoporosis and carotid atherosclerosis in postmenopausal women
　　ZHAO Ying REN Quangang GUO Hai XIE Chunsheng CHEN Qi LI Xia
　　The First Hospital of Fangshan District, Beijing 102400, China
　　[Abstract] Objective To study the correlation between osteoporosis and carotid atherosclerosis in postmenopausal women in order to find a scientific basis on comprehensive treatment and prevention and further improve their health and quality of life. Methods Intima-media thickness of bilateral common carotid arteries and internal carotid artery were examined with PHILIPS IU22 color Doppler ultrasound, the number of plaque, the hard and soft plaque and its form were observed in 30 cases of postmenopausal women and 30 cases of controls. BGP, BMD, ALP, Ca and P were measured. Results BGP and BMD decreased significantly in postmenopausal women, soft plaque was the outstanding ultrasonic characteristic, outstanding on tube antrum face, local showed different degrees of hypoechoic, hard plaque enhanced local echo. There was a significant difference between BGP and BMD in the two groups (P < 0.01). ALP increased (P <0.05). Ca and P did not change, there was no statistical significance. Conclusion There is a decrease of BGP and BMD in postmenopausal women, at the same time with the development of carotid atherosclerotic plaque and the decrease of estrogen. This is closely related to bone metabolism, the bone mineral density and soft and hard plaque forms. So there is a clinical significance to measure BGP, BMD and to carry out color Doppler ultrasound examination for the improvement of the health and the quality of life .
　　[Key words] Postmenopausal women; BGP; Bone Mineral Desity; Ultrasonography
　　绝经后妇女骨钙素（BGP）、骨形态发生蛋白（BMD）降低由于卵巢功能减退，雌激素水平下降，与骨代谢骨密度密切相关，随着绝经时间的延长，年龄的增大，BMD降低与软硬斑块及其形态有关。颈动脉内膜-中层厚度（IMT）增厚，被认为是颈动脉早期粥样硬化的标志[1]。IMT增厚作为全身动脉粥样硬化的一个表现，目前已被广泛应用于判定动脉硬化的程度[2]。超声特点表现为增厚的内膜向管腔内突出，局部不同程度低回声或等回声为软斑块，硬斑块为局部回声增强，其后方可伴有明显声影。本研究旨在探讨绝经期妇女骨质疏松与动脉粥样硬化斑块之间的相关性。
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