雌激素替代疗法对绝经后妇女血清血管 紧张素转化酶及血脂代谢的影响

目的　探讨雌激素替代疗法 (ERT)对绝经后妇女血清血管紧张素转化酶 (ACE)含量及血脂代谢的影响。方法　测定 30例健康绝经后妇女应用ERT(治疗组 )前及应用ERT 14周后血清ACE、雌二醇 (E2 )及血清甘油三酯 (TG)、总胆固醇 (TC)、高密度脂蛋白胆固醇 (HDL C)、低密度脂蛋白胆固醇 (LDL C)、脂蛋白 (a) Lp(a) ]含量 ,并与 30例健康绝经后妇女应用安慰剂 (对照组 )进行对照。结果　对照组应用安慰剂前后 ,ACE及血脂各项含量无变化 ;治疗组应用ERT后 ,ACE含量明显降低且与E2 呈负相关 ,血清TC、LDL C及Lp(a)含量降低 ,HDL C含量升高 ,TG无变化。结论　绝经后妇女补充雌激素 ,可通过降低血清ACE水平及改善血脂代谢共同发挥对心血管系统的保护作用。

The effect of estrogen replacement therapy on serum angiotensin-converting-enzyme levels and lipids metabolism in postmenopausal women

Objective To investigate the effect of estrogen replacement therapy (ERT) on serum angiotensin-converting-enzyme(ACE) levels and lipids metabolism in postmenopausal women(PMW). Methods The serum concentration of ACE, estradiols (E 2), triglycerides (TG), total cholesterol(TC), high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterolh(LDL-C) and lipoprotein(a) were assessed before and 14 weeks after placebo or ERT administration in 30 cases of healthy PMW (control group) and 30 cases of healthy PMW(ERT group) respectively.Results There was no difference in ACE concentration and lipids metabolism between before and after placebo administration in control group. In ERT group, the mean concentrations of ACE were significantly lower than baseline and there was a negative correlation between the ACE and the E 2 concentrations. The TC, LDL-C and Lp(a) concentrations were decreased respectively, the HDL-C concentration was increased and there was no change in TG concentration in ERT group.Conclusion The cooperation between the decrease of serum ACE concentration and the improvement in lipids metabolism caused by ERT may contribute to its cardiovascular protective effect in PMW.