短期与长期激素替代疗法对绝经后妇女血脂的影响

目的　观察绝经后妇女短期 (3个月 )与长期 (9～ 2 9年 )应用激素替代疗法 (HRT)对血脂的影响。　方法　 9例绝经后妇女短期单服戊酸雌二醇 (E2 )替代疗法 (ERT) 1mg/d与 30例用戊酸E2 1mg/d加醋酸甲羟孕酮 (MPA) 2mg/d的HRT。在治疗前及治疗 3个月后 ,检测血清雌二醇 (E2 )、卵泡刺激素 (FSH)和血脂水平。另外 ,对 11例绝经后妇女经多种性激素替代疗法 (mHRT) 9～ 2 9年者 ,同样检测上述各项指标及血清一氧化氮 (NO)和血管紧张素II(AngII)的水平。　结果　 (1)单服戊酸E2 (ERT)组及联合用戊酸E2 +MPA组 (HRT或mHRT)均使绝经后妇女的血清E2 达到正常水平 ,FSH水平下降 ,两种HRT后的水平均与对照组有显著差异 (P <0 .0 5 )。 (2 ) 11例用mHRT疗法 9～ 2 9年的受试者 ,NO和AngII水平与对照组比较 ,均未见明显变化 ;血载脂蛋白A1(ApoA1)从 (1.4 2± 0 .2 1)g/L升至 (1.70± 0 .38)g/L ,两者有显著差异 (P <0 .0 5 ) ,而脂蛋白 (a) [Lp(a) ]从 (0 .2 4± 0 .13)g/L降至 (0 .13± 0 .10 )g/L也有显著差异 (P <0 .0 5 ) ,其余各种血脂水平与对照组比较未见显著差异 (P >0 .0 5 )。　结论　经 3个月ERT后 ,可使血浆胆固醇水平明显下降。经过 9～ 2 9年mHRT后 ,可使血脂ApoA1水平升高 ,Lp(a)水平降低。这种血脂?

The effects of short-and long-term hormone replacement therapy on serum lipids in the postmenopausal women

Objective: To study the effects of different hormone replacement therapies with short and long term of use on serum lipids in postmenopausal women.Methods:Serum levels of 17 β-estradiol (E2),follicle stimulating hormone (FSH) and serum lipid levels in postmenopausal women were determined before and after short-term (3 months) use of estradiol valevate 1 mg/d (ERT) ( n =9) or estradiol valevate 1 mg/d plus medroxyprogesterone acetate (MPA) 2 mg/d (HRT) ( n =30). Same tests,as well as the levels of angiotensin II (Ang II) and nitric oxide (NO),were done in 11 postmenopausal women with the long term (9～29 years) use of multiple replacement therapies (mHRT).Results:(1) The concentration of E2 was increased to normal levels while FSH decreased in the postmenopausal women using ERT or HRT or mHRT. Both showed significant changes ( P <0.05) in comparison with normal control. (2) In 11 postmenopausal women treated with mHRT for 9～29 years,the levels of serum apoliprotein A1 (Apo A1) were increased from (1.42±0.21) g/L to (1.70±0.38) g/L,and the levels of serum lipoprotein (a) [Lp(a)] decreased from (0.24±0.13) g/L to (0.13±0.10) g/L. Both showed significant changes ( P <0.05). The levels of serum nitric oxide and Ang II did not change when compared with the normal control. (3) Except for the decreased serum levels of cholesterol in the postmenopausal women with ERT for 3 months,the levels of other lipids in the women with ERT or HRT were not found to be different from those before HRT.