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目的探讨产褥期妇女补钙对骨代谢及骨密度的影响。方法选取2002年1月至2003年1月北京朝阳医院208例正常产妇,根据自愿分为研究组(规律补充片剂钙)113例和对照组(仅喝牛奶未补片剂钙或极少量补片剂钙者)95例,比较产后1～3d与产后42d测定的血清钙(Ca)、磷(P)、碱性磷酸酶(ALP)及尿钙/肌酐(Ca/Cr)比值、尿羟脯氨酸/肌酐(HY/Cr)比值及腰椎和髋关节两部位骨密度。结果产褥期结束时研究组血清Ca水平明显高于对照组(P<0.05),而血清ALP及尿Ca/Cr、尿HY/Cr水平明显低于对照组(P均<0.01);总的骨密度减低发生率为19.7%,研究组骨密度减低的发生率(10.6%)明显低于对照组(30.5%)(P<0.01)。结论妊娠和哺乳会影响妇女的骨钙代谢,导致骨密度降低。片剂钙的补充有利于产褥期妇女的骨钙代谢的恢复,单纯靠食物来源补充钙是不够的。
Objective To investigate the effects of calcium supplementation on bone metabolism and bone mineral density in postpartum women. Methods 208 normal pregnant women in Beijing Chaoyang Hospital from January 2002 to January 2003 were randomly divided into study group (regular supplement calcium tablet) and control group (calcium supplementation alone or minimal supplement 95 cases of tablets of calcium, compared the serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP) and urinary calcium / creatinine (Ca / Cr) Proline / creatinine (HY / Cr) ratio and lumbar and hip joint two parts of bone mineral density. Results At the end of puerperium, the level of serum Ca in study group was significantly higher than that in control group (P <0.05), and serum ALP, urinary Ca / Cr and urine HY / Cr levels were significantly lower than those in control group (all P <0.01) Reduce the incidence of 19.7%, the study group decreased bone mineral density (10.6%) was significantly lower than the control group (30.5%) (P <0.01). Conclusion Pregnancy and lactation affect bone calcium metabolism in women, leading to a decrease in bone mineral density. Calcium supplement tablet is conducive to the recovery of bone calcium metabolism in postpartum women, simply relying on dietary supplement of calcium is not enough.