绝经后妇女激素补充治疗后同型半胱氨酸及超声心动图改变的初步观察  

Effect of hormone replacement therapy on homocysteine and echocardiography in postmenopausal women

作　　者：惠英[1] 吴宜勇[1] 肖路延[2] 唐志毅[2] 吴玉丽[3] 李燕春[1] 

机构地区：[1]卫生部北京医院妇产科,100730 [2]卫生部北京医院检验科,100730 [3]卫生部北京医院超声心动图室,100730

出　　处：《中华妇产科杂志》2002年第10期598-600,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　观察绝经后妇女激素补充治疗 (HRT)后血浆总同型半胱氨酸 [H(e) ]及超声心动图的改变。方法　将受试者分为 4组。Ⅰ组、Ⅱ组为自然绝经妇女 ,各 30例 ,其中Ⅰ组给予HRT(结合雌激素 0 6 2 5mg d ,安宫黄体酮 2mg d ,或者每月后 14d加安宫黄体酮 4mg d) 3个月 ;Ⅱ组不给予HRT ,为对照 ;Ⅲ组 2 0例 ,为已接受HRT1 5年的绝经后妇女 ;Ⅳ组 2 0例 ,为从未应用HRT的绝经后妇女。Ⅰ组、Ⅱ组受试者于接受HRT前及接受HRT 3个月后测定H(e) ;Ⅲ组、Ⅳ组受试者测定H(e) ,并行超声心动图检查。结果　Ⅰ组、Ⅱ组接受HRT 3个月前后H(e)无明显变化 ,Ⅰ组接受HRT前为(9 3± 2 5 ) μmol L ,Ⅱ组为 (9 4± 2 9) μmol L ;Ⅰ组接受HRT后H(e)为 (9 1± 2 8) μmol L ,Ⅱ组为(9 8± 3 6 ) μmol L。两组比较 ,差异无显著性 (P >0 0 5 )。Ⅲ组H(e)明显低于Ⅳ组 ,分别为 (8 0±1 3) μmol L及 (10 3± 3 2 ) μmol L。两组比较 ,差异有显著性 (P <0 0 5 )。Ⅲ组、Ⅳ组的超声心动图检查结果无明显改变。结论　短期应用HRT对H(e)无明显改善 ,长期应用HRT可降低H(e)水平。绝经后妇女应用HRT 1 5年 ,未见超声心动图有明显变化。Objective To observe the effects of hormone replacement therapy (HRT) on fasting total plasma homocysteine levels and echocardiography in postmenopausal women. Methods Subjects were assigned to four groups. Group Ⅰ:30 postmenopausal women were assigned to sequentially combined daily 0.625 mg conjugated equine estrogen (CEE) plus 2 mg medroxyprogesterone acetate (MPA) or plus 4 mg MPA daily for 14 days in a 28 day cycle for 3 months. Group Ⅱ: 30 postmenopausal women did not received HRT. Group Ⅲ: 20 postmenopausal women who took HRT for 1.5 years. Group Ⅳ: 20 postmenopausal women who never took HRT. Measurement of fasting total plasma homocysteine was performed before and after 3 months treatment in group Ⅰand group Ⅱ. Fasting total plasma homocysteine was determined and echocardiography was taken in group Ⅲ and group Ⅳ. Results Fasting total plasma homocysteine concentrations were not altered significantly after 3 months in group Ⅰand group Ⅱ [before HRT:(9.3±2.5) μmol/L,(9.4±2.9) μmol/L; after HRT:(9.1±2.8) μmol/L, (9.8±3.6) μmol/L, respectively ( P >0.05)]. Compared with women of group Ⅲ, women of group Ⅳ had statistically significant lower plasma homocysteine [(8.0±1.3)μmol/L, (10.3±3.2)μmol/L, respectively ( P <0.05)]. Echocardiography was not found any difference between those two groups. Conclusions Three months HRT has no effect on plasma homocysteine levels in postmenopausal women but the postmenopausal women using HRT 1.5 years have lower plasma homocysteine levels than those who never received HRT. Echocardiography showed no detectable changes between women received 1.5 years HRT and those who received no HRT.

关 键 词：绝经后妇女 超声心动图 雌激素替代疗法 高半胱氨酸 超声心动描记术 HRT 

分 类 号：R711.7[医药卫生—妇产科学]