雌激素替代治疗对绝经后妇女冠心病血糖、血脂等的影响

Effect of estrogen replacement therapy on glucose,insulin and lipidemia in postmenopausal women with coronary heart disease

目的 :探讨雌激素对血糖、血胰岛素及血脂的影响。方法 :对绝经后女性冠心病 (CHD) 6 0例 ,正常对照组 30例做75 g糖耐量试验 ,测空腹、餐后 1、2小时血糖 ,血胰岛素 (INS)及血脂 (ISI) ,计算胰岛素敏感指数。 CHD组给予利维爱(每片含 7-甲异炔诺酮 2 .5 mg)治疗 12周 ,然后重复上述各项目检测。结果 :与对照组相比 ,CHD组血糖、INS及 ISI均有显著性差异 (P<0 .0 0 1)。利维爱治疗后 ,血糖、INS、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白 B较治疗前降低 ,而ISI、高密度脂蛋白胆固醇、载脂蛋白 A1 水平升高 ,治疗前、后有显著性差异 (P<0 .0 0 1)。结论 :雌激素替代治疗可以降低绝经后 CHD患者的血糖、INS水平 ,降低胰岛素抵抗 (IR) ,纠正脂质代谢紊乱。

Objective:To explore the effects of estrogen on blood glucose,insulin(INS) and lipidemia.Methods:Oral glucose tolerance test(OGTT) was performed;the concentrations of fasting blood glucose(FBG),1 h and 2 h postprandial blood glucose,and serum insulin and blood lipid were measured in 60 postmenopausal women with coronary heart disease(CHD group),30 health controls(control group).Patients of CHD group received treatment of livial(ech table containe 2.5 mg of the tibolone) for 12 weeks and above-mentioned items determination were performed repeatedly.Results:As compared to control group,the levels of FBG?insulin significantly increased(P<0.001),the ISI level significantly decreased in CHD group.After treatment,FBG,INS,total cholesterol,low density lipoprotein cholesterol,apolipoprotein B levels markedly decreased(P<0.001) and ISI?high density lipoprotein cholesterol,apolipoprotein A 1 significantly elevated(P<0.001,<0.05,<0.001).Conclusion:Estrogen replacement therapy can reduce blood glucose,INS levels and insulin resistance(IR) and rectify disorder of lipid metabolism in postmenopausal women with CHD.