经皮雌激素治疗对手术绝经妇女围绝经症状和辅助性T细胞1和2平衡的影响

发布时间：2018-05-24 00:21

本文选题：雌激素治疗(ET) + 辅助性T细胞(Th)　；参考：《生殖与避孕》2015年05期

【摘要】：目的:研究经皮雌二醇(E2)凝胶对手术绝经妇女围绝经症状和T淋巴细胞分泌辅助性T细胞1(Th1)和辅助性T细胞2(Th2)型细胞因子的影响。方法:研究对象为手术绝经组,使用经皮E2凝胶(17β-E2,0.75 mg/d)3个月,用药前、后分别取外周静脉血分离T淋巴细胞,检测T淋巴细胞分泌干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)水平和IFN-γ/IL-4比值,检测外周血E2和卵泡刺激素(FSH)水平,评估围绝经症状和生存质量。生育年龄组检测外周血E2和FSH水平及T淋巴细胞分泌IFN-γ、IL-4水平和IFN-γ/IL-4比值。手术绝经组用药前、后进行自身比较,另以生育年龄组作为参考对象。结果:手术绝经组用经皮雌激素治疗(ET)后,E2水平较用药前明显升高(P0.05);FSH水平较用药前有下降趋势,但差异无统计学意义(P0.05);围绝经症状和生存质量均得到显著改善(P0.01)。手术绝经组用ET前T淋巴细胞分泌IFN-γ和IL-4的水平均明显低于生育年龄组(P0.05和P0.01),IFN-γ/IL-4水平明显高于生育年龄组(P0.01),呈现出Th1优势。手术绝经组用ET后IFN-γ较用药前显著下降(P0.01),IL-4较用药前显著上升(P0.01),IFN-γ/IL-4的水平较用药前显著下降(P0.01),与生育年龄组无明显差异,显示了Th1/Th2趋于平衡。结论:经皮雌激素治疗能显著改善手术绝经妇女的围绝经症状,同时能使手术绝经妇女的Th1/Th2趋于平衡。
[Abstract]:Aim: to study the effects of E2) gel on the secretion of helper T cell 1 (Th1) and helper T cell 2 (Th2) type cytokines by peri-menopausal symptoms and T lymphocytes in postmenopausal women. Methods: the subjects of the study were treated with 17 尾 -E _ 2 (0.75 mg 路d ~ (-1) E _ 2 gel for 3 months. The peripheral venous blood was taken to isolate T lymphocytes before and after treatment. The levels of IFN- 纬 -IFN- 纬, IL-4) and the ratio of IFN- 纬 / IL-4 were measured. The levels of E _ 2 and FSH in peripheral blood were measured to evaluate the peri-menopausal symptoms and quality of life (QOL). The levels of E2 and FSH in peripheral blood, the level of IL-4 secreted by T lymphocytes and the ratio of IFN- 纬 / IL-4 to IFN- 纬 / IL-4 were measured in reproductive age group. The postmenopausal group was compared before and after medication, and the reproductive age group was taken as reference object. Results: in the operation menopausal group, the level of estradiol (E _ 2) increased significantly after treatment with percutaneous estrogen. The level of P0.05FSH decreased, but there was no significant difference (P 0.05), and the symptoms of menopause and the quality of life were improved significantly (P 0.01). The levels of IFN- 纬 and IL-4 secreted by T lymphocytes before et in the postmenopausal group were significantly lower than those in the reproductive age group (P 0.05 and P 0.01). The level of IFN- 纬 / IL-4 in the postmenopausal group was significantly higher than that in the reproductive age group (P 0.01), showing the advantage of Th1. The level of IFN- 纬 / IL-4 in the postmenopausal group was significantly lower than that in the pre-treatment group. The level of IFN- 纬 -IL-4 increased significantly. The level of IFN- 纬 -IL-4 was significantly lower than that of the pre-treatment group. There was no significant difference between IFN- 纬 and reproductive age group, indicating that Th1/Th2 tended to be balanced. Conclusion: percutaneous estrogen therapy can significantly improve the peri-menopausal symptoms of postmenopausal women and balance the Th1/Th2 of postmenopausal women.
【作者单位】：复旦大学附属妇产科医院妇产科;
【基金】：上海市科委医学引导项目,项目号:114119b1200
【分类号】：R713

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