雌激素替代治疗对绝经后妇女血清一氧化氮和脑血流的影响

Effect of ERT on cerebral blood flow in postmenopausal women.

目的 :探讨雌激素替代治疗对绝经后妇女大脑中动脉血流的影响及其作用机制。方法 :接受结合型雌激素 0 .6 2 5mg d治疗 3个月的绝经后妇女 2 5例 ,于治疗前后对比观察血清雌二醇 (E2 )、一氧化氮 (NO)及大脑中动脉搏动指数 (PI)变化。结果 :ERT治疗3个月后血清E2 、NO浓度较治疗前明显升高 (P <0 .0 1) ,而大脑中动脉PI明显降低 (P<0 .0 1)。同时 ,服药前后NO升高与PI降低有显著相关性 (r =0 .56 ,P <0 .0 5)。结论 :ERT可增加脑血流量 。

Objective:To investigate the effect of estrogen replacement therapy(ERT) on cerebral blood flow(CBF) and the mechanism in postmenopausal women.Methods:Conjugated equine estrogen 0.625mg/d was administered daily to 25 healthy postmenopausal women for 3 months .Serum E 2,NO and PI of the middle cerebral artery were determined before and after 3 months treatment.Results:The level of serum E 2 was increased significantly from 26.97±8.43pg/ml to 66.31±12.15pg/ml(P<0.01).There were significant increase in serum NO levels,44.91±16.38μmol/L before treatment vs 92.67±31.34μmol/L 3 months after treatment.There was significant reduction in the PI of the middle cerebral artery before treatment 0.72±0.12vs 0.63±0.08 after treatment(P<0.01).There was significant correlation between the incremental rate of NO and the reduction in PI (r=0.56,P<0.05). Conclusions:ERT may increase the blood flow of brain,which may result from the elevated level of NO.