绝经后妇女长期低剂量激素替代疗法的研究——I.对海马体积与认知的影响  

The study of long-term low dose sex-hormone replacement therapy in postmenopausal women——Ⅰ.The effects on volume of hippocampus and cognitive function

作　　者：左萍萍[1] 岳赟[1] 董毅龙[1] 胡凌[2] 洪霞[2] 葛秦生[2] 

机构地区：[1]中国医学科学院基础医学研究所北京协和医学院药理室,北京100005 [2]北京协和医学院北京协和医院,北京100730

出　　处：《生殖医学杂志》2008年第2期81-84,共4页Journal of Reproductive Medicine

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

摘　　要：目的观察绝经后妇女长期低剂量激素替代疗法（HRT）对性激素水平、脑海马体积和认知功能的影响。方法选绝经后50-87岁协和医院职工182例，分为HRT组83例和对照组99例，前者服用小剂量性激素4～33年。采用酶联免疫法测血浆雌二醇（E2）、孕激素（P）和睾酮（T）水平；磁共振成像（MRI）技术，比较两组间脑海马体积占全脑容量百分比的大小；同时采用WHO-加利福尼亚大学（UCLA）词语学习（CVLT）、逻辑记忆（LM）、复杂图形（FC）、词语流畅性（VF）、结构实例（CP）、数字广度（DS）评定方法测定认知水平。结果与对照组相比HRT组E2水平在各个年龄段均明显高于对照组（P〈0．05）；P和T水平未见明显差异。MRI分析结果显示对照组海马体积从50-80岁呈急剧下降趋势，HRT组则下降得较缓和，但组间未见统计学差异，认知总分亦无明显差异。结论长期低剂量HRT可使绝经后妇女血E2维持在较高水平，并初步显示可减缓脑海马的萎缩。Objectives： To study the effects of long-term low dose sex-hormone replacement therapy （HRT） on the levels of sex hormones, the volume of hippocampus and the cognitive function in postmenopausal women. Method： One hundred and eighty-two postmenopausal women, aged 50-87 years, were recruited from Peking Union Medical College Hospital. 83 women who had received low dose HRT for 4-33 years were selected as HRT group and 99 without any HRT were enrolled as control group. Plasma levels of estradiol （E2）, progesterone （P） and testosterone （T） were assayed by enzyme linked immunosorbent assay （ELISA）. Magnetic Resonance Imaging （MRI） was performed to determine the volume of brain hippocampus. Cognitive ability was assessed by California Verbal Learning Test （CVLT）, Logical Memory （LM）, Figure Complex （FC）, Verbal Fluency （VF）, Constructional Praxis （CP） and Digit Span （DS）. Results： Plasma E2 concentration in the HRT group was significantly higher than that in the control group in every age group. No significant difference was observed in plasma P, T concentration and the total cognitive ability score between two groups. The brain hippocampus MRI showed that after the age of 50 years, hippocampus volume decreased sharply in control group while mildly in the HRT group, but the difference was not statistically significant. Conclusion： Our findings showed that long-term low dose HRT reduced the degree of hippocampus atrophy and maintained the plasma E2 concentration at a higher level in postmenopausal women.

关 键 词：激素替代疗法 绝经后妇女 雌二醇 磁共振成像 海马 

分 类 号：R711.75[医药卫生—妇产科学]