绝经激素治疗与心血管疾病

绝经增加了绝经后女性患心血管疾病的风险，绝经激素治疗（MHT）不仅能有效缓解更年期血管舒缩等症状，还可以改善心血管疾病发展的中间指标，从而减少围绝经期女性心血管疾病的发生。目前多项临床研究结果表明，对绝经后10年内和60岁以下健康女性在围绝经期开始MHT，心血管疾病发生率和死亡率有所下降。目前缺少MHT能够改善已确诊的心脏疾病的最终证据，不推荐MHT用于心血管疾病的一级预防，也不应用于冠心病的二级预防。

Clinical outcomes of extremely premature infants.

Objective　To analyze the mortality ， morbidity and a variety of perinatal and neonatal factors of extremely premature infants with gestational age of < 28 weeks.  Methods　The clinical charts of 219 infants with gestational age of < 28 weeks cared in NICU of St Louise Children’s Hospital in USA were reviewed and the data were analyzed retrospectively with SPSS software. Results　The mortality was 37.7% and NEC， grade 3 or 4 IVH and PIH were independent risk factors for death. For survivors， the mean length of hospital stay was （106.0±78.1） days； the duration of mechanical ventilation， nasal continuous positive airway pressure and oxygen administration， was （30.8±38.5）days， （10.5±11.5）days and （84.0±46.7）days， respectively. The incidences of RDS，PDA，BPD，IVH，ROP，PVL，NEC and BSI were 85.5%、62.3%、74.2%、36.5%、71.1%、12.6%、12.6% and 29.6%， respectively， with 55.9% infants discharging home on oxygen. Conclusion　 Survival without disability is possible， but the morbidities are still high in extremely premature infant with gestational age of < 28 weeks. Individualized discussions and approaches to this group of infants are suggested.