绝经后妇女雌激素替代治疗对缺血性脑血管病患者的预防及治疗作用  

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

作　　者：田文艳[1] 武红利[1] 钟亚丽[1] 

机构地区：[1]河北大学附属医院,河北保定071000

出　　处：《医学研究与教育》2009年第1期26-28,共3页Medical Research and Education

基　　金：河北省科学技术研究与发展计划项目(编号:03276196D-52)

摘　　要：目的观察替勃龙长期治疗(2年)对绝经后妇女氧化型低密度脂蛋白(ox-L DL)、一氧化氮(NO)、内皮素-1(ET-1)及颈动脉和椎动脉IMT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2.5 mg/d)和对照组。替勃龙治疗前及治疗2年后检测血脂、ox-L DL、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显著降低(P<0.05),LDL-Ch、ox-L DL、Lp(a)极显著降低(P<0.01),HDL-C略有降低(P>0.05),NO显著升高(P<0.05)。替勃龙治疗2年CCA的IMT下降26.7%(P<0.01)。CCA的RI从(0.72±0.06)下降到(0.68±0.06),ICA的RI从(0.59±0.05)至(0.56±0.05),VA的RI从(0.66±0.06)下降到(0.62±0.04),P<0.05。ECA的RI下降不明显P>0.05。结论替勃龙对绝经后妇女动脉内膜具有保护作用,对缺血性脑血管病具有预防和治疗作用。Objective To assess the effect of tibolone longterm treatment（2 years）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 138 symptomatic peri-menopausal period women were divided randomly into experimental group（tibolone were used,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 determinations of blood lipid profile,Oxidation of Low Density Lipoprotein（ox-LDL）,NO,ET-1.Noninvasive measurements of the IMT of CCA and the RI of CCA,internal carotid arter（ICA）,external carotid artery（ECA）,and vertebral arteries（VAs）were made with ultrasound at baseline and the end of the follow-up period-2 years later.Results 129 subjects have completed the study.Two years of tibolone treatment significantly decreased TC and ET-1（P〈0.05）,very significantly decreased LDL-C,ox-LDL and Lp（a）（P〈0.01）,the decrease of HDL-C was not significan（tP〉0.05）,while increased the level of NO（P〈0.05）.Two years of tibolone treatment also decreased the IMT of the CCA by 26.7%（P〈0.01）.The RI of CCA（mean±SD）decreased from（0.72±0.06）to（0.68±0.06）,the RI of the ICA decreased from（0.59±0.05）to（0.56±0.05）,and the RI of the VA from（0.66±0.06）to（0.62±0.04）（P〈0.05）.The decrease in the RI of ECA was not significan（tP〉0.05）.Conclusion Tibolone can protect arterial intima and thus appears to be useful in ischemic cerebrovascular disease.

关 键 词：替勃龙 动脉内膜 脑血管病 绝经 

分 类 号：R743[医药卫生—神经病学与精神病学]