HRT对绝经女性心血管系统的影响

发布时间：2018-03-24 12:54

  本文选题：绝经　切入点：激素补充治疗　出处：《首都医科大学》2017年硕士论文

【摘要】：目的探讨绝经后女性行激素补充治疗(Hormone Replacement Therapy,HRT)对心血管系统的保护作用及机制。方法收集近10年就诊于我院门诊的围绝经及绝经患者共194例(其中82例补充性激素,112例未补充性激素)的临床资料,依据是否进行激素补充治疗将其分为两组,比较两组之间血脂水平、颈动脉内中膜厚度(IMT)、颈动脉收缩期最大血流速度(PSV)等的差异。其中HRT组患者中,切除子宫患者予单纯雌激素(戊酸雌二醇、17β-雌二醇)或替勃龙连续补充治疗;具有完整子宫者,未绝经者予雌孕激素序贯治疗;绝经者予雌孕激素连续联合治疗或替勃龙连续补充治疗。结果(1)HRT组TC、TG、LDL水平低于非HRT组,HDL水平高于非HRT组,差异有统计学意义(P0.05);HRT组颈动脉相关指标优于非HRT组,差异有统计学意义(P0.05)。(2)将HRT组与非HRT组患者均按照绝经时间分组,分为绝经时间1年、1≤绝经时间3、3≤绝经时间5、绝经时间≥5四亚组,HRT组患者TC、TG、HDL、LDL水平均优于非HRT组,差异有统计学意义(P0.05)。(3)将处于同一绝经年限的HRT组与非HRT组两组患者血脂水平与颈动脉内中膜厚度、流速等指标进行比较:(1)血脂比较绝经时间1年,血脂水平、颈动脉相关指标水平均无明显差异(P0.05);1≤绝经时间3年,HRT组LDL水平低于非HRT组(P0.05),HDL水平高于非HRT组(P0.05),TC、TG水平无显著差异(P0.05);3≤绝经时间5年,HRT组TC、LDL水平明显低于非HRT组(P0.05),HDL水平高于非HRT组(P0.05),TG水平无显著差异(P0.05);绝经时间≥5,HRT组TC、TG、LDL水平低于非HRT组(P0.05),HDL水平无显著差异(P0.05)。(2)颈动脉比较绝经时间1年,HRT组R-ICA IMT小于非HRT组(P0.05),ICA PSV慢于非HRT组(P0.05),HRT组其余指标无明显差异(P0.05);1≤绝经时间3年,除L-CCA分叉处IMT、L-CCAPSV外,HRT组其余指标HRT组均优于非HRT组(P0.05);3≤绝经时间5年,除CCA分叉处IMT外,HRT组其余指标均优于非HRT组(P0.05);绝经时间≥5,除R-CCA IMT及分叉处IMT外,HRT组其余指标均优于非HRT组(P0.05);相同绝经年限内,HRT组与非HRT组颈动脉内膜病变及斑块无明显差异(P0.05)。(4)将HRT组患者按照HRT时间1、1≤HRT时间3、3≤HRT时间5、HRT时间≥5分为四亚组,四亚组之间血脂水平无明显差异(P0.05);颈动脉IMT、PSV、内膜、斑块无显著差异(P0.05)。结论围绝经及绝经期尽早行HRT治疗,可有效改善血脂水平,减少脂质沉积,降低颈动脉内中膜厚度、降低血流速度,延缓动脉粥样硬化等心血管疾病的发生,从而有效保护心血管。
[Abstract]:Objective to investigate the protective effect and mechanism of hormone replacement therapy (HRT) on cardiovascular system in postmenopausal women. Methods A total of 194 postmenopausal and postmenopausal women (82 of them) were enrolled in our hospital in recent 10 years. Clinical data of 112 cases without hormone supplementation. They were divided into two groups according to whether they were treated with hormone supplementation or not. The differences of blood lipid levels, carotid intima-media thickness (IMT), maximum systolic blood flow velocity (PSV) of carotid artery were compared between the two groups. Patients with resected uterus were treated with estrogen (estradiol valerate 17 尾 -estradiol) or tibolone continuously, while those with intact uterus and unmenopausal women were given sequential treatment of estrogen and progesterone. Results the level of TCG in HRT group was lower than that in non HRT group, and the difference was statistically significant (P 0.05). The carotid artery related indexes in HRT group were better than those in non HRT group. The difference was statistically significant (P 0.05). The patients in HRT group and non HRT group were divided into two groups according to menopausal time: 1 year postmenopause 1 鈮，

本文编号：1658389