小剂量维尼安用于绝经后妇女激素替代治疗30例

我科采用小剂量维尼安用于绝经妇女激素替代治疗30例,效果甚好,现总结如下. 1资料与方法 1.1 一般资料选择我科2000年1～12月门诊患者30例,自然或手术停经12个月以上,年龄最大59岁,最小42岁.30例患者绝经后有生殖道感染、泌尿道感染和精神神经症状,经对症治疗效果不佳.     

小剂量激素治疗对绝经早期妇女生活质量和血液生化的影响

目的：探讨小剂量激素对绝经早期妇女生活质量及血液生化的影响。方法：选择2001年10月～2003年9月有明显围绝经期综合征症状的绝经早期病人42例,每日口服小剂量激素及钙剂共3个月,比较用药前后临床症状及血液生化指标的变化。结果：治疗前后比较,差异均有显著性意义（P〈0.05）。对血液生化均未见不利的影响。结论：小剂量激素治疗（HT）能明显提高绝经早期妇女的生活质量,对血液生化无明显不利影响。     

低剂量激素替代治疗对绝经后妇女脂代谢的影响

目的 探讨低剂量结合雌激素（ＣＥ）和安宫黄体酮（ＭＰＡ）对脂代谢、血压及体重的影响。方法 ３４例绝经后妇女（ＰＭＷ）随机分为２组，试验组１７例，隔日口服ＣＥ０．６２５ｍｇ与ＭＰＡ２ｍｇ交替应用；对照组１７例，口服ＣＥ０．６２５ｍｇ／ｄ，每月连续服用２５ｄ，１０ｄ加用ＭＰＡ４ｍｇ。两组均连续服用４周期，于用药前后分别测定血总胆固醇（ＴＣ）、甘油酯（ＴＧ）、低密度脂蛋白（ＬＤＬ）及高密度脂蛋白９ＨＤＬ     

低剂量激素替代治疗对绝经后妇女糖代谢的影响

目的 探讨低剂量激素替代治疗（ＨＲＴ）对绝经后妇女（ＰＭＷ）糖代谢的影响。方法 将３０例ＰＭＷ随机分为两组，口服结合型雌激素（ＣＥ）０．６２５ｍｇ与安宫黄体酮（ＭＰＡ）２ｍｇ隔日交替应用１６例为试验组；口服ＣＥ０．６２５ｍｇ／ｄ，每月连服２５ｄ后１０ｄ加服ＭＰＡ２ｍｇ１４例为对照组。两组均连用４个周期，治疗前后各测定空腹血糖水平。结果 两组治疗效果组间比较无显著差异；而治疗前和治疗后空腹血糖水平比     

绝经早期激素治疗对绝经妇女生活质量的影响

目的探讨绝经早期激素治疗对绝经妇女生活质量的影响。方法围绝经期妇女100例,根据药物应用的不同分为治疗组与对照组各50例,对照组给予利维爱治疗,治疗组给予雌激素联合孕激素应。结果两组治疗前FSH与E2含量对比无明显差异,治疗后治疗组E2含量明显升高,FSH明显下降（P〈0.05）,组间比较差异有统计学意义（P〈0.05）;两组患者在治疗前的SCL-90评分无明显差异（P〉0.05）,而治疗后两组患者的SCL-90评分较治疗前均有明显升高（P均〈0.05）;治疗后两组患者的SCL-90评分比较,差异有统计学意义（P〈0.05）。结论绝经早期激素治疗应用于妇女围绝经期能有效改善性激素水平,提高妇女的生活质量,值得推广应用。     

激素替代治疗对绝经后妇女血清脂蛋白的影响

血清脂蛋白(a)[Lp(a)]是由低密度脂蛋白异生而来,是一种富含胆固醇的血脂蛋白,有报道认为Lp(a)是动脉硬化性心脏病的一个独立危险因子.当Lp(a)＞7.8mmol/L时,心肌梗死的危险性可增加2倍.我们对绝经后妇女给予激素替代治疗(HRT),观察治疗后血清Lp(a)变化,进一步认识Lp(a)的作用及HRT效果.     

低剂量激素替代治疗对绝经后妇女骨代谢的影响

目的 探讨低剂量结合型雌激素（ＣＥ）和安宫黄体酮（ＭＰＡ）联合应用对骨代谢的影响，方法３４例绝经后妇女随机分为两组，试验组１７例，ＣＥ０．６２５ｍｇ与ＭＰＡ２ｍｇ隔日口服交替应用，对照组１７例，口服ＣＤ０．６２５ｍｇ／ｄ，每月连续服用２５ｄ，后１０ｄ加用ＭＰＡ４ｍｇ。两组均连续服用４周期，于用药前后分别测定血碱性磷酸酶（ＡＬＰ）及尿Ｃａ／Ｃｒ比值。结果 实验组完成治疗者１６例，对照组完成治疗者１５     

绝经后妇女激素替代治疗对胰岛素抵抗影响的研究

目的：观察激素替代治疗对绝经妇女的糖代谢紊乱和胰岛素抵抗的影响。方法：选择绝经妇女21例，予倍美力0.625mg，每天1次，安宫黄体酮片4mg，每天1次，给药前及治疗后6个月分别检测空腹血糖（FBS）、餐后2h血糖（PBS）、空腹胰岛素（FINS）、胆固醇（TC）、促卵泡刺激素（FSH）、雌二醇（E2）等，治疗前后比较，并与正常育龄妇女20例相比较，结果：经激素替代治疗后，患者性激素水平恢复正常，FBS、PBS、FINS、TC、IRI均有明显改善，与治疗前比较有统计学意义。但胰岛素敏感状态未见改善。结论：绝经妇女经适当的激素替代治疗后，可改善糖、脂代谢紊乱和减轻胰岛素抵抗，但胰岛素分泌状态没有明显改善。     

低剂量激素替代治疗对绝经后妇女的同型半胱氨酸水平的影响

目的 探讨低剂量激素替代治疗对同型半胱氨酸水平的影响.方法 2011年在苏州大学附属第一医院就诊的接受激素替代治疗的绝经后女性与门诊体检的健康绝经后女性的血清同型半胱氨酸水平相比较,结论低剂量激素替代治疗能有效降低绝经后妇女的同型半胱氨酸水平.     

激素替代治疗对绝经后妇女凝血与纤溶功能的影响

目的 探讨激素替代治疗(hormone replacement theropy，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58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，24例仅口服钙尔奇—D作为非治疗组，另选20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(41．7：70．9)均增加，但t—PA／PAI—1比值(0．1685／0．1516)却下降(P＜005)，FPS明显下降(11．0：9．9)(P＜005)，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(70．9：58．9)，而t—PA／PAI—1比值明显增加((0．1516：0．2267)(P＜005)，FPS明显增加(9．9：13．5)(P＜005)，PC含量略有增加，但无统计意义。     

激素替代治疗更年期妇女80例分析

目的探讨小剂量激素治疗对绝经期症状的改善。方法将80例绝经期妇女（无激素替代治疗禁忌症）作为研究对象，其中40例作为治疗组，40例作为对照组，5年后比较治疗组和对照组产生的并发症及医疗开支。结果使用激素替代治疗组妇女出现骨质疏松、冠心病、老年性阴道炎、老年痴呆明显减小。结论小剂量激素替代治疗是更年期症状改善最佳方法，关键是掌握正确使用激素的要点，减少因激素使用不当产生的并发症。     

长期小剂量性激素替代疗法对绝经后妇女骨密度的影响

目的观察长期应用小剂量性激素替代疗法对绝经后妇女骨密度及骨关节痛发生的影响。方法选择北京协和医院141名绝经后医护人员,分为性激素替代治疗(HRT)组(n=63)和对照组(n=78)。HRT组接受小剂量HRT5~32年,对照组年龄与HRT组匹配,未接受HRT。比较两组治疗后腰椎、WARD三角、股骨颈、股骨粗隆和全髋总骨密度及骨关节痛的发生率。结果HRT组L2-4的骨密度比对照组高9·1%(P<0·05)。HRT组和对照组骨关节痛的发生率分别为71·4%和89·7%,两组相比差异具有显著性(P<0·05)。结论长期小剂量HRT可减少绝经后妇女骨量丢失,降低骨关节痛发生。     

雌、孕激素补充疗法对绝经后妇女膝骨关节炎症状的作用

目的观察雌、孕激素连续联合用药对绝经后膝骨关节炎(OA)患者的疗效.方法将64例有放射学证据并有关节疼痛的绝经后膝关节OA患者(45～75岁)随机分为治疗组和对照组,分别给予每日口服戊酸雌二醇(E2V)1.0mg 安宫黄体酮(MPA)2 mg和安慰剂治疗,共6个月,所有患者均同时给予乳酸钙8片/d(相当于400mg元素钙).采用0～100mm目测模拟标尺线(VAS)方法,于用药前,用药1、3、6个月末对关节疼痛等症状程度进行评价.结果用药1个月时,治疗组患者和对照组患者在夜间睡眠痛和步行时疼痛方面的变化差异有显著性(P分别为0.036和0.035).用药6个月时,两组在夜间睡眠痛、步行时疼痛及晨僵持续时间改善程度方面相比,差异均有显著性(P分别为0.026、0.027和0.011).结论雌、孕激素连续联合补充治疗对绝经后膝OA患者的临床症状有一定缓解作用.     

Effects of hormone replacement therapy on platelet activation in postmenopausal women

Somestudieshavesuggestedthatestrogenplaysaprotectiveroleagainstatherosclerosiswithoutchangesinlipidlevels 1　Othershavedemonstratedthatestrogenisassociatedwiththehemostaticsystemandisabletopreventthrombogenesis ,whichmaymediatecardiovascularprotection 2 　Ontheotherhand ,epidemiologicalstudieshaveshownthattherelativerisk (RR)ofvenousthrombogenesisandpulmonaryembolismsareincreasedinpostmenopausalwomenwhohavetakenHRT 3,4Plateletplayacrucialroleinthrombogenesis Itsfunctiondependsontheinteractio…     

更年期妇女对激素补充治疗的知晓率和接受程度调查

目的:了解更年期妇女月经改变、绝经相关症状发生时间,对激素补充治疗(HRT)的知晓、使用及相关知识需求情况,为中老年妇女生殖保健提供依据.方法:对年龄≥40岁、至少有一侧卵巢、有月经周期改变或更年期症状的妇女进行有关问卷调查.结果:共纳入326例妇女,平均年龄49.49岁,绝经年龄49.1岁,月经改变年龄45.6岁,出现更年期症状年龄46.6岁;38.6％知晓HRT的相关知识,44.2％认为更年期综合征有必要治疗,42.1％愿意接受HRT但有诸多担心顾虑,96.7％希望得到更多围绝经期保健知识;HRT使用率为5.83％.结论:更年期妇女对HRT与更年期保健知识的知晓率低,获取渠道主要为妇产科医生,应注重宣传教育,提供方便的医学支持服务,进一步提高中老年妇女的健康水平和生活质量.     

Menopausal depression:comparison of hormone replacement therapy and hormone replacement therapy plus fiuoxetine

Background To compare the efficacy and safety of hormone replacement therapy (HRT) combined with fluoxetine, with HRT alone, in post-menopausal women suffering from depression.Methods A randomized, open-label, parallel trial was applied. HRT was administered to all patients for 2 cycles, with ]4 days of estrogen therapy and 14 days of estrogen plus progesterone. Patients who were randomly assigned to the HRT plus fluoxetine group were given fluoxetine in combination with HRT. Hamilton Depression Rating Scale (HAMD), Kupperman Menopausal Index (KMI), and Clinical Global Impressions scale were used to measure the efficacy. Results One hundred and twenty-three post-menopausal patients with depression were enrolled in the study. Among them, 120 had at least one post-treatment visit and entered into the statistical analysis. The mean total HAMD scores were significantly lower, and the percentages of HAMD score reductions were higher in the HRT plus fluoxetine Group compared with the HRT Group, after at least 3 weeks of treatment, with an average difference of 5 points at the endpoint. The Clinical Global Impression-Severity and Clinical Global Impression-Improvement scores were significantly different in the 2 groups, in favor of the combination therapy. The mean total KMI was significantly lower in the Combination Group compared with the HRT Group, after at least 6 weeks of treatment, with an average 4. 5-point difference between the groups. No statistically significant differences were found in most of the adverse events reported in the Combination Group compared with the HRT group, with the exception of 3 symptoms, i. e., dry mouth, loss of appetite, and abdominal distention. They were mild to moderate in severity. Two patients in the HRT group, but none in the combination group, dropped out due to adverse events. Conclusion HRT plus fluoxetine therapy was effective in the treatment of menopausal depression with a satisfactory safety profile.     

Menopausal depression: comparison of hormone replacement therapy and hormone replacement therapy plus fluoxetine

Background To compare the efficacy and safety of hormone replacement therapy (HRT) combined with fluoxetine, with HRT alone, in post-menopausal women suffering from depression.Methods A randomized, open-label, parallel trial was applied. HRT was administered to all patients for 2 cycles, with 14 days of estrogen therapy and 14 days of estrogen plus progesterone. Patients who were randomly assigned to the HRT plus fluoxetine group were given fluoxetine in combinationwith HRT. Hamilton Depression Rating Scale (HAMD), Kupperman Menopausal Index (KMI), and Clinical Global Impressions scale were used to measure the efficacy.Results One hundred and twenty-three post-menopausal patients with depression were enrolled in the study. Among them, 120 had at least one post-treatment visit and entered into the statistical analysis. The mean total HAMD scores were significantly lower, and the percentages of HAMD score reductions were higher in the HRT plus fluoxetine Group compared with the HRT Group, after at least 3 weeks of treatment, with an average difference of 5 points at the endpoint. The Clinical Global Impression-Severity and Clinical Global Impression-Improvement scores were significantly different in the 2 groups, in favor of the combination therapy. The mean total KMI was significantly lower in the Combination Group compared with the HRT Group, after at least 6 weeks of treatment, with an average 4. 5-point difference between the groups. No statistically significant differences were found in most of the adverse events reported in the Combination Group compared with the HRT group, with the exception of 3 symptoms, i. e., dry mouth, loss of appetite, and abdominal distention. They were mild to moderate in severity. Two patients in the HRT group, but none in the combination group, dropped out due to adverse events.Conclusion HRT plus fluoxetine therapy was effectivewith a satisfactory safety profile.in the treatment of menopausal depression with a satisfactory safety profile.     

Effect of hormone replacement therapy on heart rate variability in postmenopausal women

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激素治疗对更年期综合征患者生存质量的影响

目的 综合评价激素补充治疗对更年期综合征患者生理、心理的生存质量的影响。方法 观察性研究125例更年期综合征患者,按有无经过激素治疗分为2组:A组65例患者未经任何激素类药物治疗,B组60例经过了6个月的激素补充治疗;测量基本参数,并填写改良Kupperman评分、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、绝经期生存质量量表(menopause-specific quality of life questionnaire,MENQOL)。结果 60例实施激素补充治疗的更年期女性的Kupperman指数,SAS、SDS、MENQOL的结果均显著低于未经治疗者;35例患者治疗前后4项量表评分差异也有统计学意义。结论 激素补充治疗不仅可以显著缓解患者围绝经期出现的躯体不适,还能够改善焦虑、抑郁程度,提高更年期综合征患者的生存质量。     

对绝经后激素替代治疗的重新评价

激素替代治疗(HRT)因其可有效改善妇女围绝经期症状而得到广泛应用，但最近人们发现，长期应用HRT可增加心血管疾病的发生率及激素依赖性肿瘤发生的危险性。通过系统复习文献提出，HRT的应用须慎重。