替勃龙对围绝经期妇女动脉内膜的保护作用  

Protection of tibolone to arterial intima in peri-menopausal period women

作　　者：田文艳[1] 钟亚丽[2] 武红利[3] 苏立凯[1] 

机构地区：[1]河北大学附属医院神经内科,河北保定071000 [2]河北大学附属医院功能科,河北保定071000 [3]河北大学附属医院妇产科,河北保定071000

出　　处：《临床荟萃》2009年第3期213-215,F0002,共4页Clinical Focus

基　　金：河北省科学技术研究与发展计划项目(03276196D-52)

摘　　要：目的观察替勃龙治疗对围绝经期妇女颈动脉和椎动脉内中膜厚度(IMT)和血流阻力指数(RI)及血清一氧化氮(NO)、内皮素1(ET-1)水平的影响。方法有更年期症状的围绝经期妇女138例,随机分为治疗组(替勃龙2.5mg/d)和对照组。替勃龙治疗前及治疗2年后检测血总胆固醇(TC)、甘油三酯(TG)、脂蛋白a[Lp(a)]、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、NO、ET-1及颈动脉IMT,颈动脉、椎动脉的RI。结果129例完成观察和治疗。替勃龙治疗2年后血TC、ET-1、LDL-C和Lp(a)降低(P<0.05或<0.01),TG略有降低(P>0.05),NO显著升高(P<0.05)。替勃龙治疗2年颈总动脉(CCA)的IMT下降26.7%(P<0.01)。CCA的RI从0.72±0.06下降至0.68±0.06,颈内动脉的RI从0.59±0.05降至0.56±0.05,椎动脉的RI从0.66±0.06下降至0.62±0.04(P<0.05)。颈外动脉的RI下降不明显(P>0.05)。结论替勃龙可降低血总胆固醇、LDL-C、Lp(a)、ET-1,以及颈动脉RI和颈动脉IMT厚度,升高血NO,对动脉内膜具有保护作用。Objective To assess the effect of tibolone treatment on serum nitric oxide（NO）, endothelin-1（ET-1） ,and the intima-media thickness（IMT） of the common carotid artery（CCA） and the resistance indices（RIs） of the carotid artery（CA） in peri-menopausal period women. Methods According to random number table,138 symptomatic peri-menopausal period women were divided into treatment group（tibolone, 2.5mg/d） and control group. Fasting blood samples were drawn at baseline and the end of the follow-up period-2 years later for total cholesterol（TC）,Lp（a）,low density lipoprotein cholesterol（LDL-C）, high density lipoprotein cholesterol（ HDL-C）, triglyceride（TG）, and NO, ET-1 were determined;and also noninvasive measurements of the IMT of CCA and the RI of CCA, internal carotid artery （ICA） ,external carotid artery（ECA）,and vertebral artery（VA） were evaluated with ultrasound. Results One hundred and twenty-nine subjects completed the study. Two years of tibolone treatment significantly decreased TC and ET-1（P〈0.05）,very significantly decreased LDL-C and Lp（a）（P〈0.01）, the decrease of HDL-C was not significant （P〉0.05） ,while the level of NO increased （P〈0.05）. Two years of tibolone treatment also decreased the IMT of CCA by 26.7%（P〈0.01）. The RI of CCA decreased from 0.72±0.06 to 0.68±0.06,the RI of ICA decreased from 0.59±0.05 to 0.56±0.05,and the RI of VA from 0.66±0.06 to 0.62±0.04（P〈0.05）. The decrease in the RI of ECA was not significant（P〉0.05）. Conclusion Tibolone can protect arterial intima and thus appears to be useful in preventing atheroselerosis.

关 键 词：绝经期 性腺甾类激素 血管内膜 

分 类 号：R541.4[医药卫生—心血管疾病]