Lacroix K A, Bean C, Reilly R, Curran-Celentano J
University of New Hampshire at Manchester, 03102, USA.
Clin Lab Sci. 1997 May-Jun;10(3):145-8.
To determine if menopausal women taking estrogen with and without progestin are at increased risk for thrombotic disease as evidenced by decreased levels of antithrombin III and protein C.
A case controlled study.
General community in southeastern New Hampshire.
One hundred seventy-one healthy women aged 38 to 65 years. Women were defined as premenopausal if follicle stimulating hormone levels were < 40 mIU/ml and menopausal if follicle stimulating hormone levels were > 40 mIU/ml. Menopausal women were subdivided according to hormone replacement therapy status; women not taking estrogen or progestin, and women taking estrogen with and without progestin for at least 1 year.
Significant differences in antithrombin III and protein C levels.
Premenopausal women had significantly less antithrombin III than menopausal women not taking hormone replacement therapy. Premenopausal women had significantly less protein C than menopausal women taking estrogen for at least 1 year with and without progestin.
Estrogen taken for at least 1 year with and without progestin by menopausal women will not increase the risk of thrombotic disease by lowering the levels of antithrombin III or protein C. On the contrary, estrogen is associated with an increase in circulating levels of protein C in menopausal women, and could create a protective effect not seen in premenopausal women or menopausal women not taking estrogen therapy.
确定服用雌激素加或不加孕激素的绝经后女性是否因抗凝血酶III和蛋白C水平降低而有患血栓性疾病的风险增加。
病例对照研究。
新罕布什尔州东南部的普通社区。
171名年龄在38至65岁之间的健康女性。如果促卵泡激素水平<40 mIU/ml，则女性被定义为绝经前；如果促卵泡激素水平>40 mIU/ml，则为绝经后。绝经后女性根据激素替代疗法状态进行细分；未服用雌激素或孕激素的女性，以及服用雌激素加或不加孕激素至少1年的女性。
抗凝血酶III和蛋白C水平的显著差异。
绝经前女性的抗凝血酶III水平明显低于未接受激素替代疗法的绝经后女性。绝经前女性的蛋白C水平明显低于服用雌激素加或不加孕激素至少1年的绝经后女性。
绝经后女性服用雌激素加或不加孕激素至少1年不会因降低抗凝血酶III或蛋白C水平而增加患血栓性疾病的风险。相反，雌激素与绝经后女性循环中蛋白C水平的增加有关，并且可能产生绝经前女性或未接受雌激素治疗的绝经后女性中未见的保护作用。
