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海拔4300米地区女性居民中卵巢激素与低氧血症的关系

Relationship of ovarian hormones to hypoxemia in women residents of 4,300 m.

作者信息

León-Velarde F, Rivera-Chira M, Tapia R, Huicho L, Monge-C C

机构信息

Departamento de Ciencias Fisiológicas/IIA, Universidad Peruana Cayetano Heredia, Apartado 4314, Lima, Perú.

出版信息

Am J Physiol Regul Integr Comp Physiol. 2001 Feb;280(2):R488-93. doi: 10.1152/ajpregu.2001.280.2.R488.

Abstract

Prevalence of excessive erythrocytosis, the main sign of chronic mountain sickness (CMS), is greater in postmenopausal Andean women than in premenopausal women. It is uncertain whether this greater prevalence is related to the decline in female hormones and ventilatory function after the occurrence of the menopause. To study this, we compared the physiological variables involved in the physiopathology of CMS [end-tidal CO(2) (PET(CO(2)), Torr) and end-tidal O(2) (PET(O(2)), Torr), arterial oxygen saturation (Sa(O(2)), %), and Hb concentration (g/dl)] and progesterone and estradiol levels between postmenopausal and premenopausal women, both in the luteal and follicular phases. Women residing in Cerro de Pasco (n = 33; 4,300 m) aged 26--62 yr were studied. Postmenopausal women compared with premenopausal women in the luteal phase had lower PET(O(2)) (48 +/- 4 vs. 53 +/- 2 Torr, P = 0.005) and Sa(O(2)) levels (82 +/- 12 vs. 88 +/- 12%, P < 0.005) and higher PET(CO(2)) (34 +/- 2 vs. 29 +/- 3 Torr, P = 0.005) and Hb concentration (19 +/- 1 vs. 14 +/- 2 g/dl, P < 0.005). In addition, plasma progesterone was negatively correlated with PET(CO(2)) and positively correlated with PET(O(2)) and Sa(O(2)). No clear relationship was found among the cycle phases between estradiol and the variables studied. In conclusion, our results reveal that, before menopause, there is better oxygenation and lower Hb levels in women long residing at altitude, and this is associated with higher levels of progesterone in the luteal phase of the cycle.

摘要

慢性高山病(CMS)的主要体征——红细胞增多症在绝经后安第斯女性中的患病率高于绝经前女性。目前尚不确定这种较高的患病率是否与绝经后女性激素和通气功能的下降有关。为了研究这一问题,我们比较了绝经后和绝经前女性在黄体期和卵泡期参与CMS生理病理过程的生理变量[呼气末二氧化碳分压(PET(CO₂),托)、呼气末氧分压(PET(O₂),托)、动脉血氧饱和度(Sa(O₂),%)和血红蛋白浓度(g/dl)]以及孕酮和雌二醇水平。对居住在塞罗德帕斯科(海拔4300米)、年龄在26至62岁的33名女性进行了研究。与绝经前女性的黄体期相比,绝经后女性的PET(O₂)水平较低(48±4 vs. 53±2托,P = 0.005)、Sa(O₂)水平较低(82±12 vs. 88±12%,P < 0.005),而PET(CO₂)水平较高(34±2 vs. 29±3托,P = 0.005)、血红蛋白浓度较高(19±1 vs. 14±2 g/dl,P < 0.005)。此外,血浆孕酮与PET(CO₂)呈负相关,与PET(O₂)和Sa(O₂)呈正相关。在月经周期各阶段中,未发现雌二醇与所研究变量之间存在明确关系。总之,我们的研究结果表明,在绝经前,长期居住在高海拔地区的女性氧合情况更好,血红蛋白水平更低,这与月经周期黄体期较高的孕酮水平有关。

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