低剂量激素替代治疗对绝经后妇女脂代谢的影响

EFFECTS OF LOWDOSE HORMONAL REPLACEMENT THERAPYON LIPID METABOLISM IN POSTMENOPAUSAL WOMEN

目的探讨低剂量结合型雌激素（ＣＥ）和安宫黄体酮（ＭＰＡ）对脂代谢、血压及体重的影响。方法３４例绝经后妇女（ＰＭＷ）随机分为２组，试验组１７例，隔日口服ＣＥ０．６２５ｍｇ与ＭＰＡ２ｍｇ交替应用；对照组１７例，口服ＣＥ０．６２５ｍｇ／ｄ，每月连续服用２５ｄ，后１０ｄ加用ＭＰＡ４ｍｇ。两组均连续服用４周期，于用药前后分别测定血总胆固醇（ＴＣ）、甘油三脂（ＴＧ）、低密度脂蛋白（ＬＤＬ）及高密度脂蛋白（ＨＤＬ）。结果两组治疗后ＴＣ、ＴＧ及ＬＤＬ均显著下降（Ｐ＜０．０５，Ｐ＜０．０１），高密度脂蛋白（ＨＤＬ）均轻度升高，但无统计学意义（Ｐ＞０．０５）；组间比较无差异（Ｐ＞０．０５）。两组用药后血压、体重均轻度下降，但无统计学意义（Ｐ＞０．０５）。结论绝经后妇女低剂量激素替代治疗（ＨＲＴ）可有效降低ＴＣ、ＴＧ及ＬＤＬ，对体重、血压无副作用，能有效降低冠心病的危险因素。

Objective To study the effects of lowdose hormonal replacement therapy (HRT) on lipide metabolism,blood pressure and weight in postmenopausa women(PMW).Method 34 cases of postmenopausal women(PMW) were divided randomly into trail (17 cases) and control group (17 cases). The train group received lowdose estrogen and progestogen:conjugated estrogen(CE) 0.625 mg and medroxyprogesterone acetate (MPA) 2 mg QOD alternately. The control group was treated with CE 0.625 mg daily for 25 days in combination with cycle MPA 4mg daily ,the last 10 days for four cycles.Fasting the plasma total cholesterol(TC), triglycerides(TG),HDLcholesterol and LDLcholesterol concentrations were measured before and after treatment in all subjects.Result The results showed that in both of group, TC, TG and LDL were significanfly reduce (P<0.05 ,P<0.01) and HDL was no significanfly(P>0.05),blood pressure and weigh were no significanfly reduce(P>0.05).There were no significanfly in between the train group and the control group(P>0.05).Conclusion The lowdose hormonal replacement therapy may significanfly reduce the levels of fasting plasma TC, TG , LDL and reduced risk of cardiovascular disedse.