雌孕激素治疗与围绝经期心脏病的相关性研究

目的：探讨雌孕激素治疗围绝经期心脏病的疗效比较。方法：2016年2月至2017年3月以心脏病症状就诊的45-55岁围绝经期妇女，进行动态心电图（DCG）检查，对其中单纯室性早搏、ST-T改变、T波异常者结合临床资料筛查出51例心脏病患者，平均年龄52.74岁。然后进行心脏彩色多普勒超声检查，口服雌孕激素治疗，比较激素治疗前后DCG及心脏彩超结果。结果：激素治疗前DCG异常51例，其中室性早搏28例，ST-T改变17例，T波异常6例；激素治疗后DCG异常11例，其中室性早搏7例，ST-T改变4例，未见T波异常。治疗有效率78.43%。激素治疗前后心脏彩超结果在LA左右径、LV前后径、IVS厚度方面比较无统计学差异（P>0.05）。而在EF、FS方面比较有统计学差异（P<0.05），治疗前EF 61.22±2.84%，治疗后EF 62.25±3.25%；治疗前FS 31.75±2.68%，治疗后FS 32.73±3.18%。结论：雌孕激素治疗可以影响围绝经期心电图改变，能够提高左心功能和短轴缩短率。

Correlation study between estrogen and progesterone therapy and perimenopausal heart disease

Objective: To compare the efficacy of estrogen and progesterone in the treatment of perimenopausal heart disease.Methods: From February 2016 to March 2017, 45-55 year old perimenopausal women who were diagnosed with symptoms of heart disease were examined by dynamic electrocardiogram (DCG), and 51 cases of heart disease were screened with the clinical data of simple ventricular premature beat, ST-T change and T wave abnormality. The average age was 52.74 years old. Then cardiac color Doppler ultrasound examination, oral estrogen and progestogen treatment, compared DCG and cardiac color Doppler ultrasound results before and after hormone therapy. Results: 51 cases of DCG abnormal before hormone treatment, including 28 cases of ventricular premature beat, 17 cases of ST-T change, 6 cases of T wave abnormality, 11 cases of DCG abnormal after hormone therapy, 7 cases of ventricular premature beat, 4 cases of ST-T change, and no T wave abnormality. The effective rate of treatment was 78.43%. Before and after hormone therapy, the results of echocardiography showed no significant difference in diameter of LA, LV diameter and IVS thickness (P>0.05). There were statistically significant differences in EF and FS (P<0.05), EF61.22 + 2.84% before treatment, EF62.25 3.25% after treatment, FS31.75 2.68% before treatment, and FS32.73 + 3.18% after treatment.Conclusion: estrogen and progesterone therapy can influence ECG changes in perimenopausal period, and improve left ventricular function and shortening axis shortening.