雌激素替代疗法对绝经后妇女冠心病患者血脂及胰岛素抵抗的近期影响  

EFFECTS OF ESTROGENREPLACEMENT THERAPY ON BLOOD LIPID AND INSULIN RESISTANCE IN POSTME NOPAUSAL WOMEN WITH CHD

作　　者：梁万宁 吴赛珠[1] 刘伊丽 陈秀丽 何久镛 丹笑颖 汤莉莉 戴成祥 

机构地区：[1]解放军第466医院 [2]广州第一军医大学南方医院

出　　处：《解放军医学杂志》1998年第4期263-266,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：为探索小剂量雌激素（Ｅ）及Ｅ与孕激素（Ｐ）联合应用对妇女冠心病（ＣＨＤ）的防治机制。将１０８例绝经１年以上的ＣＨＤ患者随机分为３组各３６例，甲组口服ｐｒｅｍａｒｉｎ（倍美力）０．６２５ｍｇ１／ｄ，乙组口服ｌｉｖｉａｌ（利维爱）２．５ｍｇ，１／ｄ，丙组口服安慰剂１片／ｄ，于服药前及服药第３、６个月末检测血浆性激素、血脂谱、糖代谢等各项指标的变化情况。结果显示，ｐｒｅｍａｒｉｎ治疗３个月后可使ＴＣ降低１２．８％，ＴＧ降低１７％，ＬＤＬ－Ｃ降低２９％，ＨＤＬ－Ｃ上升１４．６％，Ｉｎｓ降低３７．８％，１／ＳＧ．Ｉｎｓ上升１倍（Ｐ均＜０．０１），６个月时与３个月治疗效果相同。而ＳＧ治疗前后无显著变化（Ｐ＞０．０５）。ｌｉｖｉａｌ治疗３个月及６个月时ＴＣ降低８．７％，ＴＧ分别降低１５．６４及３３．８％、ＨＤＬ－Ｃ降低１９．７％及２８．３％（Ｐ均＜０．０１），ＬＤＬ－Ｃ、Ｉｎｓ、ＳＧ水平１／ＳＧ．Ｉｎｓ比值治疗前后无显著变化。安慰剂组治疗前后各指标均无显著变化。表明单用小剂量Ｅ可显著改善绝经后妇女ＣＨＤ患者的异常血脂谱、胰岛素抵抗，其作用显著优于Ｅ＋Ｐ联合疗法。To observe the therapeutic effect of hormone replacement on blood lipids and insulin resistance in postmenopausal women with CHD,108 postmenopausal women with CHD were randomly calssified as group A, in which women received estrogen alone therapy, was treated with 0.625 mg Premarin daily group B,which women received combined therapy with estrogen and progesterone, was treated with 2.5 mg Livial daily;and group C was treated with placebo as a control.We examined the serum levels of estradiol(E2),progesterone (P),folliclestimulating hormone (FSH), luteinizing hormone (LH),total cholesterol (TC),triglyceride (TG),high density lipoproteincholesterol (HDLC),low density lipoproteincholesterol(LDLC),serum glucose (SC),insulin (Ins) in a fasting state at baseline, and at the ends of 3 and 6 months of ERT, respectively.In group A, a statistically significant(P<001)decrease or increase versus baseline was observed in the serum levels of the following parameters after 3 and 6 treatment months:TC:-12.8%,TG:-17%,LDL:-29%,Ins:-378%,HDLC:+146%,1/SG.Ins:+98%.In group B:TC:-87%,TG:-15.6% and:-33.8%(6 month),HDLC:-197% and:-28.3% (6 months),respctively;and other parameters showed no difference.But serum E2 level was increased as significantly as that in group A.All above parameters had no statistically significant difference versus baseline after 3 and 6 treatment months in group C. It suggested that estrogen replacement therapy had a significantly clinical curative effects on blood lipids and insulin resitance in postmenopausal women with CHD.

关 键 词：绝经 冠心病 雌激素 替代治疗 胰岛素 血脂防治 

分 类 号：R541.4[医药卫生—心血管疾病]