激素替代治疗对绝经后妇女血清脂蛋白(a)的影响

Effect of hormone replacement therapy on serum lipoprotein (a) in postmenopausal women

目的 探讨戊酸雌二醇和倍美力对心血管疾病独立危险因子脂蛋白(a)[Lp(a)]的影响。方法 60例绝经后病例,按1:1随机分成两组,行连续序贯方案治疗,其中倍美力组30例口服结合雌激素0.625mg/d加醋酸甲孕酮4mg/d;戊酸雌二醇组30例口服戊酸雌二醇1mg/d加醋酸甲孕酮4mg/d。两组均连续治疗16周,于用药前、用药9周、16周取血测定血Lp(a),同时测血雌二醇水平。结果 两组用药后9周和16周Lp(a)均显著下降(P<0.01);两组间用药各时相Lp(a)水平差异无显著性(P>0.05)。两组用药前后E_2水平均显著升高(P<0.01),达正常月经周期早卵泡期水平。结论 激素替代治疗可使心血管疾病独立危险因子Lp(a)降低。

Objective To study the effects of estradial valerate on serum lipoprotein (a) within 16 weeks treatment. Methods Sixty patients of postmenopausal women were divided into 2 groups randomly. Thirty patients were given conjugated estrogen 0.625 mg daily, while 4mg medroxyprogesterone acetate was added sequentially. Thirty patients were given estradial valerate 1mg daily. Serum level of lipoprotein (a) was measured before and after 9 weeks and 16 weeks of treatment. Serum level of estradiol was measured simultaneously. Results Serum level of lipoprotein (a) was decreased after 9 and 16 weeks treatment significantly in both groups. There was no significant difference between two groups, however serum level of estradiol was increased significantly in both groups.Conclusion Postmenopausal hormone replacement therapy may reduce lipoprotein (a), an independent risk factor of coronary artery disease.