激素替代治疗联合降压药物对围绝经期原发性高血压妇女血压及内皮功能的影响

Impacts of Hormone Replacement Therapy with Hypotensive Drugs on Blood Pressure and Endothelium Function in Perimenopausal Women with Essential Hypertension

目的探讨激素替代治疗联合降压药物对围绝经期原发性高血压妇女的血压、血管内皮功能及围绝经期相关症状的影响。方法选取有围绝经期症状的轻中度原发性高血压妇女50例为研究组,按照治疗方法分为两组,单独用药组25例,即单独服用降压药物;联合用药组25例,在单独用药组服用降压药物基础上加用小剂量激素替代治疗。另选同期10例有围绝经期症状且血压正常的体检者为对照组。检测所有受检者的血压和偶联因子6(CF6)、前列环素(PGI2)、卵泡刺激素(FSH)、雌激素(E2)水平并进行Kupperman评分;研究组用药3个月后,再次测量上述各指标并进行比较。结果研究组用药前和对照组的收缩压、舒张压和PGI2、CF6水平间差异均有统计学意义(P<0.01),FSH、E2水平和Kupperman评分间差异均无统计学意义(P>0.05);单独用药组、联合用药组治疗后的血压、PGI2、CF6水平与治疗前比较,差异均有统计学意义(P<0.01);治疗后联合用药组的PGI2、E2、CF6、FSH水平及Kupperman评分与单独用药组比较,差异均有统计学意义(P<0.05)。结论激素替代治疗联合降压药物改善血管内皮细胞功能优于单纯应用降压药物,并能改善围绝经期症状,且对降压作用无不良影响,值得在围绝经期轻中度原发性高血压患者中推广使用。

Objective To investigate the impacts of hormone replacement therapy （HRT） combined with hypotensive drugs on blood pressure （BP） , endothelium function and perimenopansal syndromes （PMS） in perimenopausal women with essential hypertension （EH）. Methods Fifty mild and moderate EH patients with PMS were chosen as study group, which was divided into drug group （ n = 25, taking only hypotensive drugs） and combine group （ n = 25, taking an additional small dosage of HRT besides hypotensive drugs） , another 10 normal BP subjects with PMS were chosen as control group. We determined the levels of BP, coupling factor 6 （ CF6）, prostaglandin I 2 （ PGI 2）, follicle - stimulating hormone （ FSH）, estrogen （ E 2 ）, and scored them by Kupperman＇s; After 3 months of medication, the above - mentioned indicators were detected again in study group. Results Before medication, there was significant difference in systolic blood pressure （SBP） , diastolic blood pressure （ DBP）, PGI 2 and CF 6 between study and control groups （ P 〈 0. 01 ）, but in FSH, E 2 level and Kupperman＇s grade there was not （ P 〉0. 05） ; in drug and combine groups significant difference was noted in BP, PGI 2 and CF 6 between pre - treatment and post - treatment （ P 〈 0. 01 ） ; FSH and Kupperman＇ grade decreased, and E 2 increased in combine group, but in drug group no changes were found. Conclusion Combined HRT and hypotensive drugs prevail over single - used hypotensive drugs in upgrading vascular endothelial function, improving perimenopansal symptoms without any adverse impacts on antihypertensive effects. It is worth promoting in mild and moderate EH patients with PMS.