雌激素对绝经后妇女冠心病治疗作用的观察

目的探索雌激素对绝经后妇女冠心病的防治机制及疗效。方法将１０８例绝经１年以上的女性冠心病患者随机分为三组（各３６例），甲组口服结合雌激素（倍美力）０．６２５ｍｇ１／ｄ，乙组口服７甲基异炔诺酮（利维爱）２．５ｍｇ１／ｄ，丙组口服安慰剂１片１／ｄ，于服药前及服药后第３、６个月末检测血脂谱及ＥＣＧ，并记录心绞痛发作情况。结果倍美力治疗后可使胆固醇（ＴＣ）降低１２．８％，甘油三酯（ＴＧ）降低１７．０％，低密度脂蛋白胆固醇（ＬＤＬＣ）降低２９．０％，高密度脂蛋白胆固醇（ＨＤＬＣ）上升１４６％。利维爱治疗后ＴＣ降低８．７％，ＴＧ降低１５．６～３３．８％、ＨＤＬＣ降低１９．７～２８．３％（Ｐ值均＜００１），ＬＤＬＣ无显著变化。倍美力及利维爱治疗第３、６个月后对心绞痛症状的总有效率分别为９０９％、９３５％和８３．３％和９３．１％，对ＥＣＧ缺血性改变的总有效率分别为７６．７％、８２．１％和７８．６％、８１４％，两种药物对妇女冠心病的心肌缺血疗效差异无显著性（Ｐ＞０．０５）。结论雌激素替代治疗可显著改善绝经后妇女冠心病患者的异常血脂及心肌缺血

The effects of estrogen replacement therapy on coronary heart disease in postmenopausal women

Objective To observe the therapeutic effects of estrogen replacement therapy (ERT) on CHD in postmenopausal women. Methods 108 postmenopausal women with CHD were randomly divided into group A receiving estrogen therapy alone with 0.625 mg premarin daily, group B receiving combined therapy of estrogen and progesterone with 2.5 mg Livial daily and group C treated with one placebo tablet daily as control. We exami ned the serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL C), low density lipoprotein cholesterol (LDL C) in a fasting state at baseline as well as at the end of 3 and 6 months of ERT, respectively. Results In group A, a statistically significant ( P <0.01) decrease or increase versus baseline was observed in the serum levels of the following parameters after 3 months of treatment: TC -12.8%, TG -17%, LDL C -29%, HDL C 14.6%. There were no significant diffe rence of all above parameters versus baseline between 3 and 6 treatment months. In group B, TC -8.7%, TG -15.6% and -33.8% (6 month), HDL C -19.7% and -28.3% (6 month), respectively. The other parameters in group B showed no diffe rence. Both in group A and B, complaints of angina pectoris were relieved effectively (total effective rate 90.9% vs 83.3% and 93.5% vs 93.1%, respectively.); myocardial ischemia in ECG were improved markedly (total effective rate 76.7% vs 78.6% and 82.1% vs 81 4%, respectively). But in group C, all the above parameters showed no statistically significant difference versus baseline 3 and 6 months after treatment. Conclusion Exogenous hormone replacement with either estrogen alone or combined therapy, can beneficially affect the deleterious factors on lipid profile and has a significant curative effects on myocardial ischemia of CHD in postmenopausal women.