不同途径激素补充治疗对绝经妇女血脂影响的系统评价

发布时间：2018-03-28 00:18

本文选题：系统评价　切入点：激素补充治疗　出处：《重庆医科大学学报》2017年07期

【摘要】：目的:系统评价不同途径激素补充治疗(hormone replacement therapy,HRT)对绝经妇女血脂影响,指导临床有效安全应用。方法:检索已发表的关于比较试验组(经皮HRT)和对照组1(口服HRT)、试验组(经皮HRT)与对照组2(空白/安慰剂)对血脂及同型半胱氨酸(homocysteine,HCY)的影响的随机对照试验(randomized controlled trials,RCT);根据Cochrane协作网推荐的系统评价方法对总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、甘油三酯(triglycerides,TG)、HCY进行系统评价。结果:纳入文献22篇,研究对象共1 507人,试验组为609人,对照组1为589人,对照组2为309人。系统评价结果:试验组与对照组2相比,试验组TC值(MD=0.29,95%CI=0.03~0.55,P=0.030),HCY值(MD=0.71,95%CI=0.10~1.32,P=0.020)均比对照组明显降低;单用雌激素亚组中,两组LDL-C值均降低,且差异有统计学意义(MD=0.31,95%CI=0.13~0.48,P=0.001);两组TG值和HDL-C值的变化均无统计学差异(MD=-0.02,95%CI=-0.11~0.06,P=0.590),(MD=-0.02,95%CI=-0.13~0.09,P=0.750)。试验组与对照组1相比,TC值、LDL-C值、TG值、和HCY值的变化均无统计学差异,结果分别为:(MD=0.03,95%CI=-0.14~0.20,P=0.730),(MD=-0.04,95%CI=-0.13~0.04,P=0.270),(MD=0.05,95%CI=-0.16~0.26,P=0.650),(MD=0.32,95%CI=-0.47~1.11,P=0.420)。HDL-C值的变化无统计学差异(MD=0.01,95%CI=-0.10~0.12,P=0.860),但单用雌激素亚组中,2组HDL-C值均明显降低,且差异有统计学意义(MD=0.19,95%CI=0.10~0.28,P=0.000)。结论:经皮HRT与口服HRT相比,对血脂及HCY的影响几乎无差别,但与未接受HRT的女性相比,经皮HRT对血脂及HCY的影响是有益的,可能对心血管疾病有一级预防作用。
[Abstract]:Objective: to evaluate the effect of hormone replacement therapy on serum lipids in postmenopausal women. Methods: efficacy and safety in clinical use. Methods: the published information on serum lipids and homocysteine homocysteine homocysteine HCY (HCY) in the control group (control group) and the control group (control group 2) and the control group (oral HRT) and the control group (oral HRT) were retrieved. Randomized controlled trialsof RCTs; systematic evaluation of total cholesterol total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride triglycerides (TG), triglycerides triglycerides (TGG) based on the system evaluation method recommended by the Cochrane Collaborative Network, HDL-C, low density lipoprotein cholesterol, triglycerides triglycerides, triglycerides triglycerides, triglycerides triglycerides, triglycerides triglycerides, triglycerides triglycerides, triglycerides, triglycerides, triglycerides, triglycerides, triglycerides and triglycerides. Results: 22 articles were included, There were 1 507 subjects in the study group, 609 in the trial group, 589 in the control group and 309 in the control group 2. The results of systematic evaluation showed that the TC value of the experimental group was significantly lower than that of the control group (MD0.7195CI0.101.32P0. 020) compared with the control group. The LDL-C value of the two groups decreased, and the difference was statistically significant (P < 0.05). There was no significant difference in TG and HDL-C between the two groups. There was no significant difference in TG and HDL-C between the two groups. There was no significant difference between the two groups in the TC value, TG value, and HCY value in the study group, and there was no significant difference between the two groups in the TC value, TG value, and HCY value, and the difference was not significant between the test group and the control group (P < 0.05), but no significant difference was found between the two groups. The results showed that there was no statistical difference in MD-0.03CI-0.140.20 P0. 30CI-0.130.0495CI-0.130.04P0.270CI-0.160.26CI-0.1650CI-0.3295CI-0.471.11P0.200.HDL-C. Conclusion: there is no statistical difference between MD0.01-95CI-0.100.12P0.8600.but the HDL-C values of two groups in estrogen subgroup are significantly lower, and the difference is statistically significant. Conclusion: compared with HRT, there is almost no difference in blood lipid and blood lipid in the two groups of estrogen subgroups. Conclusion: compared with HRT, there is almost no difference in blood lipid and blood lipid between the two groups of estrogen subgroup (P < 0.05), and there is no significant difference between the two groups. Conclusion: there is no statistical difference between MD0.3295CI-0.47 and 1.11P0.200.HDL-C, and there is almost no difference in the effect of HRT on blood lipids and serum lipid levels in the two groups of estrogen subgroup A (P = 0.100.28P0.0.000). Conclusion: there is no statistical difference in the changes of MD0.3295CI-0.140.20. HDL-C levels in MD-0.01-95CI-0.1012P0.860,0. However, the effects of percutaneous HRT on blood lipid and HCY were beneficial to women who did not receive HRT, and may have a primary preventive effect on cardiovascular disease.
【作者单位】：重庆医科大学公共卫生与管理学院医学与社会发展研究健康领域社会风险预测治理协同创新中心;
【分类号】：R711.75

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