更年期激素替代治疗对脂蛋白和载脂蛋白的影响

EFFECT OF HORMONE REPLACEMENT THERAPY ON SERUM LIPOPROTEIN AND APOLIPOPROTEIN

目的：探讨更年期激素替代治疗对脂蛋白和载脂蛋白的影响。方法：将４５例更年期病人按２∶１随机分为２组，实验组３０例接受口服国产短效戊酸雌二醇每天１ｍｇ，对照组１５例口服结合雌激素每天０．６２５ｍｇ，并与醋酸甲孕酮４ｍｇ连续序贯应用治疗１６周，分别于用药前、用药后９周、１６周测定血脂蛋白和载脂蛋白水平。结果：实验组ＨＤＬ、ＡｐｏＡⅠ上升，ＡｐｏＢ、ＡｐｏＣⅢ、ＡｐｏＥ下降；对照组ＨＤＬ、ＡｐｏＡⅠ、ＡｐｏＡⅡ上升，ＡｐｏＥ下降。用药后９周，对照组ＡｐｏＡⅠ和ＡｐｏＣⅡ明显高于实验组；用药后１６周，对照组ＡｐｏＡⅡ和ＡｐｏＣⅢ明显高于实验组；其余血脂和载脂蛋白结果，两组间差异无显著性。结论：激素替代治疗对血脂构成有正性作用。

Objective: To determine the effects of postmenopausal hormone replacement therapy on serum lipoprotein and apolipoprotein. Methods: 45 patients were divided at random into 2 groups: 30 were each given 1 mg of domestic estradiol valerate, 15 were each given 0.625 mg of estradiol conjugated estrogen daily. 4 mg of medroxyprogesterone acetate was added sequentially in both groups. Serum lipoprotein and apolipoprotein were measured before and after treatment (week 9 and week 16). Serum estradiol and FSH were measured at the same time. Results: HDL, ApoAⅠ increased and ApoB, ApoCⅢ, ApoE decreased in the experimental group; HDL, ApoAⅠ, ApoAⅡ increased and ApoE decreased in the control group. After 9 weeks' treatment, ApoAⅠ and ApoCⅡ of the control group were higher than those of the experimental one; after 16 weeks' treatment, ApoAⅡ and ApoCⅢ were higher than those of the experimental one. Conclusion: Postmenopausal hormone replacement therapy may improve the constitution of serum lipoprotein and apolipoprotein.