Bone mass in women with hip fractures.

Bone mass was measured by single photon absoptiometry in 52 women with hip fractures and compared to controls of similar age. No difference in the forearm bone mineral content (BMC) was detectable between the groups. Extracapsular fractures had lower forearm BMC than intracapsular fractures, but these differences were eliminated by allowance for age. Clinical management therefore was not influenced by such measurements.     

甲亢131Ⅰ治疗前后前臂骨密度及相关生化指标变化分析

目的 探讨131Ⅰ治疗甲状腺功能亢进(简称甲亢)前后对前臂骨密度及骨代谢相关生化指标的影响.方法 102例甲亢患者治疗前、治疗后3及6个月分别检测其血清TT3、TT4、FT3、FT4、TSH以及骨钙素(BGP)、血清碱性磷酸酶(ALP)、血清钙(Ca)和无机磷(P)的含量,治疗前后均采用DTX-200型双能X线骨密度仪检测其前臂骨密度(BMD)值.结果 1、甲亢131Ⅰ治疗后痊愈组、好转组和甲低组3个月至6个月前臂骨密度值呈上升趋势,治疗后6个月与治疗前的BMD值比较差异有显著性(P<0.05);甲亢治疗无效组BMD与治疗前BMD比较无明显差异(P>0.05).2、甲亢131Ⅰ治疗前与治疗后6个月BGP、ALP、血清Ca比较差异有显著性(P<0.05);甲亢治疗无效组与治疗前比较无明显差异(P>0.05).结论 甲亢患者经131Ⅰ治疗后前臂骨密度及其骨代谢指标均有较好恢复.     

Body mass index does not influence the outcome of anti-incontinence surgery among women whereas menopausal status and ageing do: a randomised trial

Introduction and hypothesis  

A few series comparing the clinical efficacy of midurethral slings in obese and postmenopausal patients are available. The aim of the study was to assess clinical efficacy of suburethral tape operations for the surgical treatment of female stress urinary incontinence (SUI) stratified by obesity, menopause and ageing.     

Mortality, morbidity and long-term results in surgically treated hyperthyroid patients. Review of 597 cases

An analysis is presented of 597 cases of Graves' disease or toxic multinodular goitre surgically treated in 1956-1980. The mortality rate was only 0.2%. The incidence of postoperative haemorrhage was 0.2%, damage to the recurrent laryngeal nerve 3.2%, postoperative thyrotoxic crisis 1.7%, acute hypoparathyroidism 2.2% and acute postoperative respiratory failure due to tracheomalacia 0.5%. Early complications were significantly more common among the patients with Grave's disease than in the multinodular goitre group. Thyroid function was re-evaluated in 116 patients after a mean postoperative interval of 9 years. Hyperthyroidism had recurred in ten of them and six were hypothyroid (8.6 and 5.2%). The evolution of the thyroid functional status was not significantly related to the pathology or to the sex or age of the patients.     

RUNX2 alleles associated with BMD in Scottish women; interaction of RUNX2 alleles with menopausal status and body mass index

Bone mineral density (BMD) is influenced by both environmental and genetic factors. We previously reported the association of the RUNX2 A allele with increased bone mineral density (BMD) and protection against a common form of osteoporotic fracture within a Geelong population. We genotyped 991 women from a Scottish cohort to decipher the role of RUNX2 alleles in regulating BMD. The alleles of RUNX2 within the glutamine–alanine repeat were determined by MspA1I restriction digest. Allele frequencies estimated from Scottish cohort were G allele, 0.87 ± 0.01; A allele, 0.08 ± 0.01; and 11Ala alanine deletion allele, 0.05 ± 0.01. Analysis of covariance (ANCOVA) was used to adjust for the covariates weight and age for BMD at the femoral neck (FN). The A allele was associated with higher FN BMD (P = 0.035) within a postmenopausal subgroup of the population (n = 312). The effect of RUNX2 A alleles increased with increasing weight; A alleles were associated with FN BMD in those above the median BMI (BMI > 25), while no association was observed in thin/normal (BMI ≤ 25) postmenopausal women. Glutamine variants and an alanine insertion were identified within the group. These data suggest that the RUNX2 alleles are associated with BMD in a menopause- and weight-dependent manner.     

Bone mass status in different degrees of chronic renal failure.

Bone mineral density (BMD) was evaluated in 69 patients with chronic renal failure (CRF) and in healthy controls matched for age, sex, and, for women, menopausal status. Both appendicular (predominantly cortical) and axial (predominantly trabecular) bone mass were measured. Appendicular BMD was measured by single photon absorptiometry on the distal forearm and axial BMD was measured by dual photon absorptiometry on the lumbar spine. Patients were divided into three groups on the basis of creatinine clearance: group 1, 58 to 36 ml/min; group 2, 30 to 18 ml/min; group 3, 15 to 9 ml/min. Both appendicular and axial BMD decreased with the worsening of renal failure. Parathyroid hormone levels were inversely correlated with the values of appendicular BMD. BMD values were significantly lower in postmenopausal than in premenopausal women. Months of menopause were inversely correlated with axial BMD values. Appendicular BMD was lower in CRF patients than in controls, and both appendicular and axial BMD were significantly lower in postmenopausal uremic women than in postmenopausal healthy women.     

Spinal bone mass after long-term treatment with L-Thyroxine in postmenopausal women with thyroid cancer and chronic lymphocytic thyroiditis

This study investigated the effect of long-term treatment upon bone density with L-Thyroxine in postmenopausal women compared with untreated postmenopausal women with climacteric symptoms. We measured spinal bone density in three groups (n=84) of postmenopausal women: (A) those treated with TSH-suppressive dosis of L-Thyroxine for a medium of 5 years after removal of thyroid cancer; (B) those on L-Thyroxine treatment for a median of 9 years after being diagnosed with chronic lynfocitic thyroiditis (CLT); and (C) those with no thyroid disease or other known pathology and without any treatment. There were no differences in dietary calcium intake and daily activity between untreated and L-Thyroxine-treated women. Measurements of bone mineral density were performed at spine level L1–L4 using a dual X-ray densitometer and serum thyroid-stimulating hormone (TSH), thyroid hormones, and bone markers (serum osteocalcin, procollagen I, urinary calcium), and PTH levels were assayed and found to be within normal ranges. Women receiving L-Thyroxine after thyroid cancer had slightly higher FT4 levels compared with women who had CLT and lower TSH levels, with serum T4 and T3 levels normal and similar in both groups. No significant differences were found in spinal bone density after L-Thyroxine treatment between Groups A and B and compared with Group C. Bone loss according to 2 SD below reference standards (age and sex matched) was found in the 12.9% of L-Thyroxine-treated patients versus 22.6% of untreated women. No correlation was found between bone loss and thyroid hormone levels and duration of treatment. Our data suggest that long-term L-Thyroxine therapy in postmenopausal women maintaining near physiological levels of thyroid hormones is not associated with significant axial bone loss, therefore other factors should be considered when this occurs.     

Impact of menopausal status on the outcome of pelvic floor physiotherapy in women with urinary incontinence

Introduction and hypothesis

The purpose of this study was to evaluate the effectiveness of pelvic floor muscle training in pre- and postmenopausal women using a quality-of-life questionnaire.

Methods

We retrospectively reviewed the medical records of 96 patients with urinary incontinence who participated in a pelvic floor muscle-training (PFMT) program at the Physiotherapy Department in a London University Hospital between January 2010 and August 2011.

Results

A period of supervised PFMT resulted in significant improvement in symptoms of stress urinary incontinence, urge urinary incontinence, urgency, frequency, and nocturia, irrespective of menopausal status.

Conclusions

Pre- and postmenopausal women experience similar outcomes in relation to urinary symptoms following a short-term supervised PFMT.     

Extra-adrenal and metastatic pheochromocytoma: The role of131I meta-iodobenzylguanidine (131I MIBG) in localization and management

From June, 1980, to August, 1983,¹³¹I MIBG scintiscans were performed in 353 patients with suspected pheochromocytomas. Extra-adrenal pheochromocytomas were identified in 15 of 18 patients who at operation were proven to have such tumors and normal adrenal glands. Conventional localization studies, often repeated, had failed to localize these tumors in nearly all cases. Nine of the extraadrenal pheochromocytomas were found within the middle mediastinum. This group of unique tumors required further specialized localization studies with augmented computed tomography (CT) scans for specific anatomical delineation. These complementary studies allowed for precise planning of surgical excision of the tumors, which required cardiopulmonary bypass in some patients. Extraadrenal pheochromocytomas were identified in a family with no other endocrinopathies. The tumors in 3 patients from 3 different generations all were perirenal and involved the vena cava. ¹³¹I MIBG scintiscans detected metastatic lesions in 40 patients with malignant pheochromocytomas. Metastases were not readily demonstrated in 4 patients. The diagnosis of malignant and metastatic pheochromocytoma was first made by the scintiscan findings in 5 patients.¹³¹I MIBG scans were not false-positive in any cases and were falsenegative in 10.5% of 95 patients proven to have pheochromocytomas by biochemical evidence or operation.Ten patients have been treated for malignant pheochromocytomas with therapeutic doses of¹³¹I MIBG. Five patients have had objective responses with diminution in size of metastases or primary malignant tumor and a decrease in the secretion of catecholamines.This agent has been found to be of great value in detecting pheochromocytomas that often have defied all other means of localization.¹³¹I MIBG concentrates in most malignant pheochromocytomas, and preliminary results suggest that it will be very useful in the treatment of this disease.

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Resumen El diagnóstico de feocromocitoma con frecuencia es más simple que establecer la localización anatómica del tumor, lo cual es difícil, especialmente cuando el feocromocitoma es maligno, extraadrenal o bilateral. Aproximadamente el 10% de los feocromocitomas se origina en tejido cromafino ubicado en algún lugar entre la base del cráneo y la vejiga. La tomografía computadorizada de tercera generación es extremadamente precisa en la localización de lesiones intra-adrenales, pero no es muy util en la identificación de feocromocitomas extra-adrenaleso metastásicos. Hasta muy recientemente no existía modalidad alguna capaz de proveer documentación anatómica y funcional del tumor con anterioridad a la intervención quirúrgica. La síntesis de la I¹³¹ metayodo-benzilguanidina (I¹³¹ MIBG) ha hecho posible obtener imágenes scintigráficas de feocromocitomas y de tejido cromafino hiperplásico.Entre junio de 1980 y agosto de 1983, scintigramas con I¹³¹ MIBG fueron realizados en 353 pacientes con sospecha de feocromocitoma. Se identificaron feocromocitomas extra-adrenales en 15 de 18 pacientes quienes ulteriormente demonstraron tener tales tumores, con glándulas suprarrenales normales. Los estudios convencionales de localización, con frecuencia realizados en forma repetida habían fallado en casi todos los casos. Nueve de los feocromocitomas extra-adrenales fueron hallados en el mediastino medio. Este grupo especial de tumores requirió estudios de localización adicionales con tomografía computadorizada aumentada para el logro de la delineación anatómica específica. Tales estudios complementarios hicieron posible la planeación precisa de la excisión quirúrgica, la cual necesitó circulación extracorpórea en algunos casos. Feocromocitomas extraadrenales fueron identificados en una familia, la cual no exhibió otras endocrinopatías. Los tumores en 3 pacientes provenientes de 3 generaciones diferentes fueron todos de ubicación peri-renal con compromiso de la vena cava.Los estudios con I¹³¹ MIBG detectaron lesiones metastásicas en 40 pacientes con feocromocitomas malignos. En sólo 4 pacientes las metástasis no pudieron ser fácilmente demostradas. El diagnóstico de feocromocitoma maligno y metastásico fue hecho en forma primaria por la scintigrafía en 5 pacientes. Los scintigramas con I¹³¹ MIBG no han dado resultados positivos falsos, en caso alguno, y han dado resultados negativos falsos en 10,5% de 95 pacientes con feocromocitoma comprobado por evidencia bioquímica o por operación.Diez pacientes han sido tratados para feocromocitoma maligno con dosis terapéuticas de I¹³¹ MIBG. Cinco pacientes han manifestado respuesta objetiva con reducción del tamaño de las metástasis o del tumor primario maligno con disminución en la secreción de catecolaminas.Este agente ha demostrado ser de gran valor en la detección de feocromocitomas que han desafiado todos los otros métodos de localización. La I¹³¹ MIBG se concentra en la mayoría de los feocromocitomas malignos, y los resultados preliminares sugieren que habrá de ser de gran utilidad en el tratamiento de esta enfermedad.

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Résumé De juin 1980 à août 1983, 353 malades suspects d'être porteurs de phéochromocytomes ont été soumis à la scintigraphie à l'iode marqué: I¹³¹ métaiodobenzylguanidine (I¹³¹ MIBG). Des phéochromocytomes extra-surrénaliens ont été découverts chez 15 des 18 sujets suspects d'être porteurs de telles lésions extra-surrénaliennes, ce qui fut constaté lors de l'intervention qui démontra que les surrénales étaient normales. Les autres méthodes conventionnelles n'avaient pas permis de localiser ces tumeurs dans la majorité des cas. Neuf des phéochromocytomes extra-surrénaliens furent découverts dans la partie moyenne du médiastin. Ce groupe de tumeurs implique la mise en oeuvre de techniques particulières en plus du scanner pour localiser la tumeur. Ces explorations complémentaires permettent de planifier l'intervention chirurgicale qui peut nécessiter l'emploi d'une circulation extra-corporelle. Des phéochromocytomes extra-surrénaliens ont été découverts dans une famille qui ne présentait pas d'autres endocrinopathies. Les tumeurs chez 3 malades appartenant à 3 générations différentes siégeaient hors de la surrénale et intéressaient la veine cave.La scintigraphie à l'I¹³¹ marqué a permis de découvrir des métastases chez 40 malades porteurs d'un phéochromocytome malin, mais fut en défaut dans 4 cas. Le diagnostic de phéochromocytome malin avec métastase fut porté initialement chez 5 malades. La scintigraphie ne se solda par aucun faux positif mais 10,5% de faux négatifs furent constatés chez 95 malades où la présence d'un phéochromocytome fut prouvée par les données biologiques ou opératoires.Dix malades atteints de phéochromocytomes malins ont été traités par l'I¹³¹ marqué. Cinq d'entre eux accusèrent une diminution de volume de la tumeur et des métastases et une diminution de la sécrétion des catécholamines. L'iode marqué: I¹³¹ méta-iodobenzylguanidine permet de déceler les phéochromocytomes qui échappent aux autres explorations. Le fait qu'il s'accumule électivement au niveau de la tumeur permet de penser qu'il pourra jouer un rôle actif dans le traitement de l'affection.

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Presented at the International Association of Endocrine Surgeons at Hamburg, September 1983.     

Bone mass and vitamin D levels in women with a diagnosis of fibromyalgia

Summary

No differences in either bone mineral density or serum 25OHD levels have been found between 205 women with fibromyalgia (both pre- and postmenopausal) and their controls. However, a lack of the expected 25OHD summer rise was observed in patients.

Introduction

Contradictory data have been published regarding a possible association between fibromyalgia and osteoporosis or hypovitaminosis D. Most studies, however, have been performed in small size samples and have excluded postmenopausal women. We decided to study this association in a larger sample of fibromyalgia patients including both pre- and postmenopausal women.

Methods

Two hundred five patients were recruited from a clinic specializing in fibromyalgia and 205 healthy controls were enrolled from the census of a Primary Care Center. Controls were matched with patients by age and the time of the year they were included in the study. Bone mineral density (BMD) was measured by DXA. Serum 25OHD, iPTH, P1NP, and CTX were also determined.

Results

BMD was similar in both groups (lumbar spine, 0.971?±?0.146 g/cm² in patients and 0.970?±?0.132 g/cm² in controls; femoral neck, 0.780?±?0.122 g/cm² and 0.785?±?0.117 g/cm², respectively). 25OHD levels were also similar: 23.0?±?9.5 ng/ml and 24.1?±?9.6 ng/ml. However, while controls showed the usual summer rise in 25OHD, fibromyalgia patients did not. PTH did not show seasonal changes, but on average was higher in patients (51 pg/ml vs. 48 pg/ml; p?=?0.034). P1NP or CTX were similar in both groups.

Conclusions

No differences in BMD were found between patients and controls. As for 25OHD, a lack of its expected summer rise was observed. It is doubtful whether this has any homeostatic consequence. We consider that the association reported in other studies is merely circumstantial, and not due to the intrinsic characteristics of these disorders.     

Recurrent thyroid cancer. Role of surgery versus radioactive iodine (I131)

OBJECTIVE: This retrospective study compared treatment and survival of patients with recurrent well-differentiated thyroid cancer that was diagnosed exclusively by I131 scanning, or by clinical examination. SUMMARY BACKGROUND DATA: Despite the usual excellent prognosis of differentiated thyroid cancer, approximately half of patients who developed a recurrence eventually succumb to the disease. It has been speculated, but not proven, that recurrent disease detected solely by I131 scanning may offer a better prognosis than recurrences detected clinically and be amendable to I131 ablative therapy without the addition of surgical resection. METHODS: Seventy-four cases of recurrent differentiated thyroid cancer were identified retrospectively and examined regarding the location of recurrence, mode of detection of recurrent disease, treatment of recurrence, and outcome of patients. Using Fischer exact testing, outcome results for recurrences detected exclusively by I131 scan was compared to that of clinically diagnosed recurrences; among clinically detected recurrent cases, treatment with surgery only was compared to surgery/I131 ablation. Kaplan-Meier actuarial survival curves were generated for clinically detected recurrent cancer treated by surgery only and compared to those treated by surgery and I131 ablation using Gehan-Wilcoxon and log-rank analysis. RESULTS: Recurrences located most commonly were regional (53%), followed by local (28%), distant metastasis (13%), and combined locoregional (6%). Among patients whose recurrence was detected scintigraphically, only 9.5% had persistence of disease or were dead of disease compared to 54.0% of patients with clinically detected recurrences. Radioactive iodine ablation in scintigraphically detected recurrences salvaged 18 of 20 patients (90%). Among clinically detected recurrences, surgery alone salvaged 12 of 21 patients (57%), whereas the addition of I131 ablation to surgery salvaged only 3 of 15 patients (20% p = 0.05). CONCLUSION: The probability of dying or living with persistent disease after treatment of recurrent thyroid cancer is less for I131 detected recurrences compared to clinically diagnosed recurrences; I131 ablation without surgery constitutes adequate therapy for scintigraphically detected recurrences. In clinically recurrent disease, the addition of I131 ablation to curative resection does not appear to improve survival.     

Worsened oncologic outcomes for women of lower socio-economic status (SES) treated for locally advanced breast cancer (LABC) in Pakistan

Two hundred and thirty-seven women, undergoing multimodality treatment for locally advanced breast cancer (LABC), were retrospectively analyzed for age, menopausal status, socio-economic status (SES), tumor size, nodal involvement, tumor grade, estrogen and progesterone receptor (ER, PR) status and tumor stage. Primary purpose was to assess outcomes of these patients treated in a low-income country as defined by the World Bank and using limited-level treatment resources as defined by Breast Health Global Initiative (BHGI) guidelines. Secondary objectives included correlation of predictive and prognostic features with event-free survival (EFS) and overall survival (OS) at 5 years.Predictors of decreased EFS or OS included lower SES [P = 0.05 (95%CI 0.34–1.0) and P = 0.1 (CI 0.29–1.14)], larger tumor size [P = 0.01 (95%CI 1.06–1.59) and P = 0.3 (CI 0.86–1.50)] and positive lymph node status [P = 0.04 (95% CI 1.0–1.55) and P < 0.0001 (CI 1.37–2.64).In women diagnosed with LABC in Pakistan, patients with lower SES had larger, more aggressive tumors with worsened survival outcomes. Optimal breast cancer care warrants consideration for health care policies that address access to diagnostic and treatment services for financially disadvantaged women.     

The influence of body mass index on the long-term survival of patients with renal cell carcinoma after tumour nephrectomy

OBJECTIVE

To assess whether under‐ or overweight at the time of surgery has any effect on the survival of the patients with renal cell carcinoma (RCC), as obesity increases the risk of developing RCC.

PATIENTS AND METHODS

We prospectively evaluated 780 patients who had nephrectomy for RCC between 1990 and 2005. We used uni‐ and multivariate Cox proportional hazards models to assess the effect of body mass index (BMI), tumour stage, Fuhrman grade, age, sex, histological type and performance status on cancer‐specific survival (CSS). Patients were grouped according to BMI (in kg/m²), as underweight (<18.5), normal (18.5–<25), overweight (25–<30) and obese (≥30).

RESULTS

The median (range) follow‐up was 5.3 (0.5–15.4) years, the patients being followed until June 2006; 254 patients died during the follow‐up. Multivariate analyses of all patients showed that tumour stage, Fuhrman grade, Karnofsky performance status, age, sex and BMI were independent prognostic factors for CSS. While underweight patients had a significantly worse prognosis than those of normal weight, overweight or obese patients had a similar outcome to that of patients of normal weight. In a subgroup analyses including patients with localized RCC only, there was a strong tendency to less aggressive disease in the overweight group (P = 0.081).

CONCLUSIONS

Being underweight is an unfavourable and new risk factor for CSS in patients with RCC treated by nephrectomy. Although not significant, there seems to be a limited favourable prognostic effect of overweight on CSS in patients with localized RCC.     

乳腺癌芳香化酶抑制剂治疗期间骨丢失的长期随访结果

目的 评估绝经后激素受体阳性早期乳腺癌患者术后5年芳香化酶抑制剂（aromatase inhibitor,AI）辅助内分泌治疗过程中的骨丢失情况,为骨健康管理提供依据。方法 本研究为前瞻性观察性研究,入组绝经后激素受体阳性早期乳腺癌患者,接受股骨颈、全髋和腰椎L1-L4等部位的双能X线骨密度检测。AI辅助内分泌治疗前进行基线骨密度检查,治疗期间每年检查骨密度1次。分析AI治疗过程中骨密度变化以及骨质疏松发生率。结果 2013年11月至2016年8月共纳入131例患者,中位年龄60岁,中位绝经年龄50岁,AI治疗时间60～100个月。中位随访86个月,AI治疗5年期间患者腰椎、股骨颈、全髋骨密度逐年下降,5年骨密度总下降率分别为6.90%、5.68%、7.14%,其中第1年骨密度下降最快,第2～5年骨密度平稳下降。腰椎骨密度第1年变化率显著高于第2～5年骨密度变化率（P＜0.01）。进一步分层分析显示,基线骨密度、年龄以及体质量指数值未影响患者骨密度下降率。5年间共17例（17%）患者新发骨质疏松,其中15例为基线骨量低下患者,76%出现在腰椎（13/17）,骨折发生率2%（2/100）。结论 绝经后早期乳腺癌患者5年AI辅助内分泌治疗期间骨密度呈持续下降趋势。应加强AI治疗期间的骨健康管理,早期干预减少骨质疏松的发生。     

长期强的松治疗对绝经前SLE患者骨密度的影响

目的探讨长期强的松治疗对绝经前系统性红斑狼疮(SLE)患者骨密度的影响。方法142例SLE患者均为绝经前女性,年龄12~40岁(平均29·5岁)。正常对照78例女性,年龄15~39岁(平均28·9岁),排除影响骨代谢的各种急慢性疾病。应用HOLOGIC QDR4500双能量X线骨密度仪检测腰椎和股骨近端的骨密度值,测定血清雌二醇、雌三醇。结果①绝经前SLE患者骨量减少、骨质疏松发生率分别为42·96%、14·79%,均显著高于正常对照组(P值均<0·01);②骨质疏松和骨量减少患者服用强的松的时间、总剂量均显著高于骨量正常患者(P值均<0·01);③绝经前患者雌二醇与正常对照无显著差异,而雌三醇明显升高(P<0·01)。结论①长期服用强的松的绝经前SLE患者骨量减少和骨质疏松发生率均显著增高;②SLE患者骨量减少和骨质疏松的发生与使用强的松的时间和总剂量有关;③绝经前SLE患者雌三醇产生增多,可能对骨密度具有保护作用。     

超声评价低剂量长期激素替代疗法对绝经后妇女颈动脉的影响

目的应用高频超声显像技术观察低剂量长期激素替代疗法(HRT)对绝经后妇女颈动脉粥样硬化的影响。方法对HRT组(使用低剂量HRT 5年及以上的女性)68例与对照组78例,超声测量其颈动脉的内膜-中层厚度(IMT)和斑块情况,同时测定两侧颈内动脉的收缩期峰值血流速度(PSV)、血管阻力指数(RI)。结果(1)平均IMT HRT组为(0.089±0.022)cm,对照组为(0.093±0.029)cm,两组有显著性差异(P<0.01)。(2)动脉硬化斑块发生率HRT组7.7%,对照组12.7%,两组有显著性差异(P<0.05)。动脉硬化斑块多发生在动脉分叉处。(3)软斑块、混合性斑块HRT组明显少于对照组,而硬斑块HRT组明显多于对照组。软斑块HRT组占1.7%,对照组占4.5%;混合性斑块HRT组占3.1%,对照组占6.7%;硬斑块HRT组占2.6%,对照组占1.3%,(P均<0.05)。(4)HRT组斑块厚度小于对照组,血管狭窄的发生率低,两组有显著性差异(P<0.05)。(5)HRT组PSV:(65.61±26.55)cm/s,RI:(0.67±0.08),对照组分别为(64.82±27.22)cm/s及(0.68±0.08),两组无明显差异(P>0.05)。结论低剂量长期HRT对绝经后妇女颈动脉有保护作用。