长期小剂量性激素疗法对绝经后妇女血压及血管活性因子的作用  

The effects of long-term and low-dose of hormone replacement therapy on blood pressure and blood vessel bioactive factors in postmenopausal women

作　　者：聂敏[1] 孙梅励[1] 宋爱羚[1] 葛秦生[2] 

机构地区：[1]中国医学科学院,中国协和医科大学,北京协和医院内分泌科,北京100730 [2]中国医学科学院,中国协和医科大学,北京协和医院妇产科,北京100730

出　　处：《生殖医学杂志》2005年第6期321-324,共4页Journal of Reproductive Medicine

基　　金：科技部1999年度攀登-特别支持费资助(国科基字[1999]045)

摘　　要：目的观察绝经后妇女长期用小剂量性激素替代疗法(HRT)后,其血压及血管活性因子水平的变化。方法选择北京协和医院的140例绝经后医护人员,其中63例经小剂量HRT 5～32年(HRT组),77例年龄匹配未经HRT者为对照组。分别测量血压及取血测血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)和一氧化氮(NO)浓度。结果HRT组与对照组比较,雌二醇(E2)水平(中位数,四分位间距)分别为9．2 pmol／L,8．4及5．8 pmol／L,9．1,明显升高(P<0.05),收缩压分别为(126．7±14．4)mmHg及(132．4±19．8)mmHg,明显低于对照组(P<0．05);舒张压分别为(79．7±7．9)mmHg及(79．6 ±10．4)mmHg,血清卵泡刺激素(FSH)水平(54．4±18．9)IU／L及(60．4±24．4)IU／L,血浆AngⅡ(中位数,四分位间距)分别为46．0 ng／L,31．1及44．4 ng／L,33．0,NO分别为63．8 μmol／L,58．9及56．0 μmol／L,94．8和PRA分别为0．14 Pg·L-1 ·h-1,0．11及0．12 Pg·L-1·h-1,0．10,均无统计学差异(P>0．05)。结论绝经后妇女长期应用小剂量HRT收缩压明显低于对照组,而舒张压、PRA、AngⅡ和NO水平与对照组相比差异无显著性。Objective ：To investigate the effects of long-term and low-dose of hormone replacement therapy （HRT） on blood pressure, the plasma renin activity （PRA）, angiotensin Ⅱ （AngⅡ and nitric oxide （NO） in postmenopausal women. Methods： A total of 140 postmenopausal women were selected from the medical staff of the Peking Union Medical College Hospital. Of those, 63 subjects had been treated with low-dose sex hormone for over 5 （5-32） years （HRT group）, and 77 age-matched subiects who have never received hormone therapy served as the control. The PRA, AngⅡ, NO and the blood pressure in these two groups of postmenopausal women were evaluated. Results. The serum levels of estradiol in HRT group were significant higher than those in control group（median, inter-quartile range： 9.2 pmol/L,8.4 vs. 5.8 pmol/L, 9.1） （P〈0.05）and the systolic blood pressure in HRT group was significantly lower than that of control （126.7±14.4mmHg vs.132.4±19. 8 mmHg, P〈0.05）. Diastolic blood pressure（79.7±7.9 mmHg vs. 79.6±10. 4 mmHg）, the serum levels of FSH （54.4±18. 9 IU/L vs. 60.4±24.4 IU/L）, the plasma levels of PRA （median, interquartile range ; 0.14μg· L^- 1· h^-1, 0.11 vs. 0.12μg· L^-1 · h^-1, 0.10）, AngII （median, inter-quartile range; 31.1 ng/L ,46.0 vs. 33.0 ng/L,44.4） and NO （median, inter-quartile range;63. 8 μmol/L, 58. 9 vs 56. 0μmol/L, 94.8）showed no significant difference between HRT group and control group （P〉0. 05）. Conclusions. Long-term and low-dose of HRT can decrease the systolic blood pressure, and have no effects on diastolic blood pressure, the plasma levels of PRA, AngII, and NO in postmenopausal women.

关 键 词：性激素替代疗法 一氧化氮 肾素活性 血管紧张素Ⅱ 

分 类 号：R459.1[医药卫生—治疗学]