应用小剂量利维爱对绝经后妇女的防治效果和意义

对绝经后妇女应用小剂量利维爱为期 3年的前瞻性研究。服药剂量每日 1 .2 5mg (1 / 2量组 ) 3 9例和每日 0 .62 5 mg (1 / 4量组 ) 1 2例。于用药前及用药后每 6个月随诊 ,分别观察骨密度、尿 Ca/ Cr比值、血脂 ,子宫大小、子宫内膜厚度 ,体重及副反应等。结果 :两组经 SPA、DXA和 QCT测量骨密度均有上升。以 QCT更为明显 ,其中 1 / 2量组治疗后上升 1 5 .4% ,与治疗前相比有显著差异 (P<0 .0 0 1 ) ,1 / 4量组治疗后上升 9.0 % ,与治疗前相比无显著差异 (P>0 .0 5 ) ;两组尿 Ca/ Cr比值相应的下降率分别为 1 1 .8%与8.6%。两组甘油三脂相应下降 1 6.5 %和 2 6.7% ;两组子宫内膜厚度虽有所增加 ,但平均厚度均未超过 0 .5 cm。以上各项两组相比均无显著差异 (P>0 .0 5 )。阴道出血率 2 6%(1 3 / 5 1 ) ,其中 77% (1 0 / 1 3 )为绝经 3年内开始服药 ,63 % (8/ 1 3 )为服药 1年内开始出血。体重在 1 / 2量组增加约 5 %而 1 / 4量组无明显增加 ,但两组相比也无明显差异 (P>0 .0 5 )。结论 :绝经后妇女应用 1 / 2量利维爱可提高骨密度 ,1 / 4量利维爱可维持骨量 ;甘油三脂均下降 ,参与保护心血管的作用 ,对子宫内膜无明显刺激作用。结果显示利维爱能有效地用于绝经后妇女激素替代治疗 ,但例数较少 ,年龄段有?

The effect of low dose Livial in prevention and management of postmenopausal women

Objective:To assess the effect of low dose L ivial in prevention and managementof postmenopausal women. Design:A prospective clinical trial. Setting:Outpatients from Division of Reproductive Endocrinology and Infertility, Departmentof Obstetrics and Gynecology,Peking Union Medical College Hospital. Subjects:Total of 5 1 menopausal women divided two groups:1 .2 5 mg QD (1 / 2 dosage group) 3 9cases and0 .62 5 mg QD(1 / 4doage group) 1 2 casesMethods:Bonedensity,urine Ca/Cr,totalcholesterol,triglycerides,HDL-and L DL- cholesterol,endometrium,body weightwere checked before and after treatmentevery 6 months until3 years. Results:After treatment for3 years,bone density in 1 /2 dosage group showed increase of 1 5 .4% (P<0 .0 0 1 ) and 1 /4 dosage group showed of 9.0 % (P>0 .0 5 ) ; urine Ca/Cr showed decrease of1 1 .8% and8.6% ;and blood triglycerides lowered to 1 6.5 % and2 6.7% respectively.Average endometrial thickness in the two groups were less than 0 .5 cm.There were no difference between two groups (P>0 .0 5 ) .Thirteen cases had vaginal bleeding among which 1 0 received treatment within 3 years after menopause.Eight of then had vaginal bleeding within1 year of treatment.Body weight showed some increase in 1 /2 dosage group,but remained stationary in 1 /4 dosage group.No significant difference between the two groups(P>0 .0 5 ) . Conclusion:Metabolites of L ivial estrogen,androgen and progesterone biological activity.Postmenopausal women using 1 /2 or 1 /4 dosages for 3 years showed increase in bone density,decrease in triglycerides and no stimulation on the endometrium.It proves thatlow dose L ivial can be used effectively in the prevention of osteoporosis,and prevention of cardiovascular system,with no stimulation on the endometrium.