结合雌激素-醋酸甲羟孕酮替代防治绝经后妇女的血脂紊乱

Conjugated estrogens-medroxyproges-terone acetate in replacement treatment of blood lipid disturbance for postmenopausal women

目的 :探讨结合雌激素 醋酸甲羟孕酮(Pre)替代防治绝经后妇女的血脂紊乱及心血管疾病。方法 :64例绝经后妇女 ,随机分为服药组 32例 ,年龄 (60±s 4 )a ;对照组 32例 ,年龄 (5 9± 6)a ,采用Pre作为绝经后激素替代治疗药物 ,服药组口服Pre 1片 ,qd× 2 8d为一个周期 ,连用 6个周期 ,对照组在观察期间仅给安慰剂服用。服药前后 ,用放射免疫法测定血雌二醇 (E2 )、促卵泡刺激素(FSH) ;采用酶法及酶联免疫双抗体夹心法测定血浆脂蛋白的浓度。结果 :服用Pre 6个周期后 ,E2 上升至卵泡中期水平 ,FSH显著降低 [E2 为 (75± 5 0 )ng·L- 1;FSH为 (38± 2 0 )IU·L- 1],低密度脂蛋白胆固醇 (LDL C)和脂蛋白 (a) [LP (a) ]显著降低[(2 .7± 0 .5 )mmol·L- 1;(98± 169)mg·L- 1],而高密度脂蛋白胆固醇 (HDL C)显著升高 [(1.82±0 .10mmol·L- 1]。结论 :绝经后妇女使用激素替代治疗 ,能改变其体内激素水平 。

AIM: To investigate conjugated estrogens medroxyprogesterone acetate (Pre) in prevention and treatment of blood lipid disorder and cardiovascular disease for postmenopause women. METHODS: Sixty four postmenopause women were randomly divided into two groups. Taking medicine group of thirty two patients (age (60± s 4)a) received Pre 1 tablet, po qd for 28 d as one course. It continued for six courses. The control group of thirty two patients (age (59±6)a) received placebo in the period of observation. Before and after taking medicine, estradiol (E 2) and follicle stimulating hor mone (FSH) were determined with radioimmunoassay. The concentrations of plasma lipoproteins were determined with enzyme and enzyme linked immunoassay double antibody methods. RESULTS: After six courses of taking medicine, E 2 increased to the level of secondary follicle, FSH descended markedly ((E 2 (75±50)ng·L -1 ,FSH(38±20)IU·L -1 ). Low density lipoprotein cholesterol (LDL C ) and lipoprotein (a)(lp (a)) descended significantly (2.7±0.5)mmol·L -1 ,(98±169)mg·L -1 . Highdensity lipoprotein cholesterol increased significantly (1.82± 0.10 )mmol·L -1 . CONCLUSION: After taking hormone replacement therapy, postmenopausal women can change the level of hormone, ameliorate lipid disturbance.