雌激素替代治疗对绝经后妇女冠心病者血脂代谢及抗氧化作用的研究

Effects of estrogen replacement therapy on lipid metabolism and antioxidative capacity in postmenopausal women with coronary heart disease

对32例绝经后妇女（PMW）冠心病患者（CHD组）进行雌激素替代治疗（ERT），以观察对其血脂代谢及机体抗氧化水平的影响。另选取绝经后健康妇女30例为对照组。CHD组口服尼尔雌醇（CEE3）每月2次，每次2mg，连用6个月，分别于用药前、用药后3个月及6个月检测总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL－C）、低密度脂蛋白胆固醇（LDL－C）、脂蛋白（a）［LP（a）］、氧化修饰低密度脂蛋白（Ox－LDL）、丙二醛（MDA）及超氧化物歧化酶（SOD）。结果表明ERT前CHD组与对照组比较LP（a）、Ox－LDL及MDA水平明显升高（P＜0．05），而SOD总活力显著降低；CHD组于ERT后TC无明显变化，TG呈升高趋势（P＞0.05），而LDL-C、TC／HDL－C和LDL－C／HDL－C显著下降（P＜0．01），LP（a）也明显降低（P＜0．05），而HDL－C显著上升（P＜0．01）；血浆Ox－LDL、血清MDA显著下降（P＜0．01），血清SOD总活力明显上升（P＜0．05），提示ERT不仅能显著改善PMW之CHD患者血脂紊乱，而且能有效地提高机体抗氧化水平。

The study was aimed to investigate the effects of Estrogen Replacement Therapy (ERT) on lipid metabolism and its antioxidative property. 32 postmenopausal wnmen patients with coronary heart disease were selected as the experimental group and 30 age-matched postmenopausal healthy women served as control. Conjugated Equine Estrogen (CEE3) was given to the experimental group in a dose of 2 mg twice per month for period of six months. The levels of lipids (TC,TG, HDL-C), plasma oxidatively modified LDL (Ox-LDL), serum malondialdehyde (MDA), superoxide dismutase (SOD) and lipoprotein (a) [LP (a)] were measured before and after 3, 6 months therapy in experimental group and in control group only once. The result showed that the leve1 of LP (a),Ox-LDL. MDA was much higher and SOD activity much lower in experimental group than control; while after ERT, TC remained no change, TG rose slightly and LDL-C,TC/HDL-C, LDL-C/HDL-C decreased significantly, LP (a) level was in the same trend as LDL-C;meanwhile HDL-C level elevated significantly. The antioxidative capacity in experimental group also changed greatly after ERT, with Ox-LDL,MDA leved dropped and SOD activity elevated. This suggests that ERT not only improves lipid disorder in postmenopausal women with coronary heart disease, but also effectively raises the patient's antioxidative capacity in vivo.