绝经期激素补充治疗对血清E_2、血脂及子宫内膜的影响

The Influence of Human Supplementary Menopausal Hormonotherapy on Serum E2, Blood-lipid and Endometrium

目的 :观察不同绝经年限妇女激素补充治疗 (HRT)对血清E2 、血脂及子宫内膜的影响。方法 :对 38例绝经1～ 5年和 30例绝经 5年以上妇女连续联合使用激素补充治疗半年 ,用药前后观察绝经期症状、血清E2 、血脂四项、子宫内膜厚度及内膜细胞形态变化。结果 :用药后两组之绝经期症状均明显改善 ,Kupperman评分显著下降 ;用药后E2 均显著升高 (P <0 .0 1 ) ,FSH显著下降 (P <0 .0 5 ) ;绝经 1～ 5年组总胆固醇 (CHOL)、甘油三酯 (TG)、低密度脂蛋白 (LDL)均显著下降 ,高密度脂蛋白 (HDL)显著上升 ;而绝经 5年以上组用药后CHOL、LDL有所下降 ,而TG、HDL有升高趋势 ,但差异无统计学意义。两组HRT后子宫内膜均较HRT前增厚 ,1～ 5年组以混合型及增殖期型比例为主 ,而 5年以上组以萎缩型为主。内膜 >5mm者 ,1～ 5年组以增殖期型及伴分泌象为主 ,而 5年以上组以增殖期型为主。 1～ 5年组非计划性出血率高于 5年以上组。结论 :不同绝经年限妇女使用激素补充治疗(HRT)均能显著改善绝经期症状 ,但在血脂代谢及对子宫内膜的影响上却存在差异 ,使用HRT时宜根据绝经年限。

Objective:The influence of human supplementary menopausal hormonotherapy on serum E2,blood-lipid and endometrium of the women of different ages was observed.Methods:38 cases of menopause from one to five years and 30 cases of menopause for more than five years were used human supplementary menopausal hormonotherapy for half a year.Before and after the administration,the climacteric symptom,serum E2,the depth of endometrium as well as the changes of cell shape in tunica intima were observed.Results:After the administration,the climacteric symptom of the above two groups had been obviously improved.The Kupperman evaluation had been obviously decreased.E2 was significantly raised ( P <0.01) and FSH was significantly decreased ( P <0.05).Conclusion:The use of supplementary menopausal hormonotherapy at different menopauses can significantly improve the climacteric symptom,but as far as blood-lipid metabolism and the influence on endometrium are concerned,there exist differences.The use of supplementary menopausal hormonotherapy should be used according to the time of menopause and the purpose of treatment.