低剂量与长期性激素替代疗法对绝经后妇女血脂水平的影响

目的探讨绝经后妇女低剂量与长期的性激素替代疗法(HRT)对血脂水平的影响。方法研究对象为北京协和医院女职工141人,年龄50~87岁、平均68岁,其中绝经后低剂量HRT 5~31年63人为HRT组。以年龄匹配78人为对照组。空腹12~14 h取静脉血,分离血清,检测血脂、脂蛋白和载脂蛋白等九项指标。结果HRT组与对照组比较:甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白AⅠ(ApoAⅠ)、脂蛋白(a)[Lp(a)]两组之间差异无统计学意义;总胆固醇(TC)、TC/HDL-C、载脂蛋白E(ApoE)、载脂蛋白CIII(ApoCIII)和载脂蛋白B(ApoB)差异有统计学意义。结论绝经后妇女经低剂量与长期的HRT可使TC、ApoB、ApoCIII、ApoE、TC/HDL-C水平明显下降。血脂水平的下降对心血管系统有保护作用,并可降低心血管事件发生和发展的危险性。

Effect of low-dose long-term hormone replacement therapy on serum lipids in postmenopausal women

Objective: To study the effects of low-dose and long-term hormone replacement therapy(HRT) on blood lipids in postmenopausal women.Methods: A total of 141 postmenopausal female medical staff(aged 50 to 87 years,average 68 years) from Peking Union Medical College Hospital were recruited.Among them,63 received low-dose HRT for 5~31 years were taken as HRT group,and other 78 age-matched postmenopausal women as the control group.Vein blood was taken from the women fasting for 12~14 h and the serum isolated for the determination of serum concentrations of lipid,lipoprotein and apolipoprotein.Data were analyzed with SPSS(statistical) software and the statistical significance was considered to be P<0.05.Results: In comparison with the controls,the levels of TG,HDL-C,LDL-C,ApoA,Lp(a) in the women of HRT group had no significant difference,but those of TC,TC/HDL-C,ApoE,ApoCIII and ApoB significantly decreased.Conclusions: The serum levels of TC,LDL-C,ApoB,ApoCIII,ApoE decrease obviously in the(postmenopausal) women receiving low-dose and long-term HRT.The decrease of blood lipid levels may protect cardiovascular system and reduce the risk of cardiovascular events.