激素替代治疗对113例绝经后妇女乳腺密度的影响

Effect of Hormone Replacement Therapy on Mammographic Density in Postmenopausal Women

目的:探讨激素替代治疗(HRT)方案对绝经后妇女乳腺密度的影响。方法:113例绝经后妇女分为4组:①组1 每天口服结合型雌激素(CE)0.625 mg和安宫黄体酮(MPA)4.000 mg;②组2 每天口服 CE 0.625 mg和MPA 2.000 mg;③组3 隔日口服7-甲异炔诺酮2.500 mg;④组4 每天口服CE 0.625 mg(子宫切除者)。服药前和服药后6个月由放射科医师进行乳房X线检查,乳腺密度采用Wolfe标准分类。结果:组1、组2的乳房相密度增加分别为33.3％和25.8％,明显高于组3(8％)和组4(10.5％);组1乳房相增加也明显高于组2(P<0.05)。结论:不同的HRT方案对乳腺显示不同的作用效果。结合雌孕激素治疗比单用CE和7-甲异炔诺酮有较高的危险性;应用低剂量HRT方案和7-甲异炔诺酮对某些病人可能较为有利。

Objective: To evaluate the effect of different hormone replacement therapy (HRT) regimens on mammographic density in postmenopausal women. Methods: One hundred and thirteen patients were divided into 4 groups: (D group 1 was given conjugated estrogen (CE) 0. 625 mg plus medroxyprogesterone acetate (MPA) 4 mg every day; (2) group 2 was given CE 0. 625 mg plus MPA 2 rag every day; ?group 3 was given OrgOD 14 2. 5 mg every two days; @ group 4 was given only CE 0. 625 mg every day. Mammography was taken and analyzed by independent radio-logist blinded to HRT regimens before and 6 months after administration. Mammographic density wasclassified according to Wolfe criteria. Results: The mammographic density increased was much higher in group 1 (33. 3% ) and group 2 (25. 8% ) than that in group 3 (8% ) or group 4 (10. 5% ) . And the increase of mammographic density of group 1 was significantly higher than that of group 2( P < 0. 05). Conclusion: Different HRT regimens have different effects on the breast. There is a higher risk an increase in breast density with combined estrogen-progestogen treatment than with estrogen alone and OrgOD 14. Lower dose of progestogen may have some benefit and OrgOD14 may be another alternative in some patients.