绝经妇女血浆一氧化氮、内皮素的水平及补充性激素后的变化  

Changes of Nitric Oxide and Endothelin Plasma Levels and Effects of Hormone Replacement Therapy in Postmenopausal Women

作　　者：赖爱鸾[1] 张建生[1] 丁磊[1] 张李松[1] 王成彬[2] 曾强 

机构地区：[1]首都医科大学附属复兴医院妇产科,北京100038 [2]解放军总医院生化科

出　　处：《中华妇产科杂志》2000年第4期222-224,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　探讨绝经妇女雌激素下降后血浆一氧化氮 (NO)与内皮素 (ET)水平的变化 ,及服用结合雌激素加安宫黄体酮对NO、ET水平的影响。方法　选择 70例绝经妇女作为绝经组 ,2 8例有围绝经期症状的妇女作为围绝经组 ,2 6例月经周期正常的妇女作为正常月经组。绝经组中 30例服用结合雌激素加安宫黄体酮治疗者为绝经I组 ,另外 2 0例服用碳酸钙治疗者为绝经II组。绝经I组及绝经II组用药时间均为 6个月。以上各组均取静脉血测定NO、ET、促卵泡激素 (FSH)、雌二醇 (E2 )的含量。结果　围绝经组和绝经组NO[(2 3.8± 15 .1)、(2 0 .0± 12 .1) μmol/L]与正常月经组 [(33.2±15 .5 ) μmol/L]比较 ,明显降低 (P <0 .0 5 ;P <0 .0 1)。绝经组ET[(6 5 .3± 16 .2 )pg/L]与围绝经组和正常月经组 [(5 9.3± 14.2 )、(5 1.1± 15 .6 )pg/L]比较 ,明显上升 (P <0 .0 1)。绝经I组治疗前NO(2 0 .3±11.1) μmol/L、ET(6 2 .6± 18.9)pg/L及E2 (7.9± 4.8)ng/L ,与治疗后NO(32 .9± 16 .1) μmol/L、ET(5 2 .2± 12 .0 )pg/L及E2 (47.5± 12 .9)ng/L比较 ,差异均有极显著性 (P <0 .0 1) ;绝经II组NO、ET、E2用药前后无明显变化 (P >0 .0 5 )。E2 与NO之间呈正相关关系 ,而与ET、FSH呈负相关关系。Objectives To investigate the changes of plasma levels of nitric oxide(NO) and endothelin(ET) when the estrogen level dropped and to assess the effects of hormone replacement therapy (HRT) on NO, ET plasma levels in postmenopausal women. Methods Twenty six women with regular menses (regular mense group), twenty eight perimenopausal women with climacteric symptoms (perimenopausal group), seventy healthy postmenopausal women(postmenopausal group) were in duded in this study. Thirty postmenopausal volunteers received oral conjugated estrogen /medroxyprogesterone acetate (post menopause group Ⅰ) and twenty others took only calcium (post menopause group Ⅱ) for 6 months. Plasma NO, ET, follicle stimulation hormone (FSH) and estradiol (E 2) levels were measured for all the women. Results The levels of NO were significantly lower in perimenopausal group (23.8±15.1) μmol/L and postmenopausal group (20.0±12.1) μmol/L than those of regular mense group (33.2±15.5)μmol/L ( P <0.05, P <0.01). The mean concentrations of ET were significantly higher in both of perimenopausal (59.3± 14.2) pg/L and postmenopausal groups (65.3±16.2)pg/L than those of regular mense group (51.1±15.6) pg/L ( P <0.01). Plasma NO (32.9±16.1) μmol/L and E 2 (47.5±12.9) pg/L values were significantly higher, and ET (52.2±12.0) pg/L values significantly lower than baselines of NO (20.3±11.1) μmol/L, E 2 (7.9±4.8) ng/Land ET(62.6±18.9) pg/L, respectively, in menopause group Ⅰ after treatment for 6 months ( P <0.01).There was no difference in NO, ET and E 2 concentrations in menopause group Ⅱ before and after taking calcium for 6 month ( P >0.05). E 2 had a significant positive correlation with NO and significant negative correlation with ET and FSH. Conclusions HRT results in an increased level of NO and decreased level of ET in postmenopausal women. This may be one of the mechanisms by which HRT provides cardiovascular benefit.

关 键 词：绝经后期 雌激素替代疗法 一氧化氮 内皮缩血管肽类 心血管系统 

分 类 号：R711.5[医药卫生—妇产科学]