激素替代治疗对绝经后妇女凝血与纤溶功能的影响

The Effect of Hormone Replacement Theropy on Coagulation and Fibrinolytic Function in Postmenopausal Women

目的 探讨激素替代治疗 (hormonereplacementtheropy ,HRT)对绝经后妇女凝血与纤溶功能的影响及对心血管的保护作用。方法 选取围绝经期门诊 5 8例相对健康的绝中妇女作为研究对象 ,其中 34例自愿接受HRT治疗一年以上的作为治疗组 ,2 4例仅口服钙尔奇 -D作为非治疗组 ,另选 2 0例健康育龄妇女作为正常妇女组。抽取研究对象的血浆 ,采用ELISA法测定组织纤溶酶原激活物 (t-PA)、纤溶酶原激活物抑制剂 (PAI - 1)、游离蛋白S(FPS)、蛋白C(PC)含量。结果 与正常妇女组相比 ,非治疗组的 (t-PA) ( 7.0∶10 .7)、PAI -I( 4 1.7∶70 .9)均增加 ,但t-PA/PAI - 1比值 ( 0 .16 85 / 0 .15 16 )却下降 (P <0 0 5 ) ,FPS明显下降 ( 11.0∶9.9) (P <0 0 5 ) ,PC含量无明显改变 ;与非治疗组相比 ,HRT组t-PA( 10 .7∶13.4 )增加、PAI - 1下降 ( 70 .9∶5 8.9) ,而t-PA/PAI - 1比值明显增加 ( ( 0 .15 16∶0 .2 2 6 7) (P <0 0 5 ) ,FPS明显增加 ( 9.9∶13.5 ) (P <0 0 5 ) ,PC含量略有增加 ,但无统计意义。结论 HRT可以改善绝经后妇女凝血与纤溶功能 。

Objective To study the effects of hormone replacement therapy (HRT)on coagulation and fibrinolysis function in postmenopausal women.Methods 58 postmenopausal women aged 37 to 60 year-old were recruited.Among them 34 women received HRT as a HRT group,the other 24 women did not received HRT as parrell-controlled group.In addition,there were twenty healthy reproductive women as normal women group.The plasma concentration of tissue-type plasminogen activator(t-pa) antigen,plasminogen activator inhibitor(PAI-1) antigen,free protein S(FPS)antigen and protein C(PC) antigen were measured in above three groups by ELISA.Results Comparison with normal women group,both t-PA antigen(7.0vs10.7) and PAI-1 antigen(41.7vs70.9) are increased in no-HRT group,but the ratio of t-PA to PAI-1(0.1685/0.1516) was decreased( P <0.05),and FPS antigen was decreased significantly(11.0vs9.9) in no-HRT group( P <0.05).Compared with no-HRT group,t-PA antigen was increased slightly(10.7vs13.4)( P <0.05),PAI-1 antigen was decreased siguificantly (70.9vs 58.9)( P <0.05),the ratio of t-PA to PAI-1 was increased significantly,FPS antigen was increased (9.9vs13.5)(P<0.05),PC antigen was increased slightly in HRT group.Conclusions Our trial results suggested that HRT can improve the function of coagulation and fibrinolysis in postmenopausal women and supposed that HRT may play a role in prevention of cardiavascular.