Schaumberg D A, Buring J E, Sullivan D A, Dana M R
Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Ave E, Boston, MA 02215, USA.
JAMA. 2001 Nov 7;286(17):2114-9. doi: 10.1001/jama.286.17.2114.
Postmenopausal hormone replacement therapy (HRT) use is common in the United States. Some research suggests that estrogen may have detrimental effects on the tear film and could influence the development of dry eye syndrome, but few data are available on this relationship.
To determine the relationship of HRT and dry eye syndrome.
DESIGN, SETTING, AND PARTICIPANTS: The Women's Health Study, a large cohort study in which 25 665 postmenopausal women provided information about use of HRT at baseline (1992), 12, and 36 months and dry eye syndrome at 48 months.
(1) Clinically diagnosed dry eye syndrome, as reported by participants; (2) severe symptoms (both ocular dryness and irritation either constantly or often); and (3) either clinically diagnosed dry eye syndrome or severe symptoms, compared between women who used HRT vs those who did not.
For the combined end point of either clinically diagnosed dry eye syndrome or severe symptoms, the multivariable-adjusted odds ratios were 1.69 (95% confidence interval [CI], 1.49-1.91) for estrogen use alone and 1.29 (95% CI, 1.13-1.48) for estrogen plus progesterone/progestin use compared with no HRT use. Each 3-year increase in the duration of HRT use was associated with a significant 15% (95% CI, 11%-19%) elevation in risk of clinically diagnosed dry eye syndrome or severe symptoms. Results were similar for the combined end point of clinically diagnosed dry eye syndrome and severe symptoms.
These data suggest that women who use HRT, particularly estrogen alone, are at increased risk of dry eye syndrome. Physicians caring for women who are taking or considering HRT should be apprised of this potential complication.
绝经后激素替代疗法（HRT）在美国很常见。一些研究表明，雌激素可能对泪膜有不良影响，并可能影响干眼症的发展，但关于这种关系的数据很少。
确定HRT与干眼症之间的关系。
设计、地点和参与者：女性健康研究，一项大型队列研究，其中25665名绝经后女性在基线时（1992年）、12个月和36个月时提供了HRT使用信息，并在48个月时提供了干眼症信息。
（1）参与者报告的临床诊断干眼症；（2）严重症状（持续或频繁出现眼干和眼刺激）；（3）使用HRT的女性与未使用HRT的女性相比，临床诊断干眼症或严重症状的情况。
对于临床诊断干眼症或严重症状的综合终点，单独使用雌激素的多变量调整优势比为1.69（95%置信区间[CI]，1.49 - 1.91），与未使用HRT相比，雌激素加孕激素/孕酮使用的优势比为1.29（95%CI，1.13 - 1.48）。HRT使用时间每增加3年，临床诊断干眼症或严重症状的风险显著升高15%（95%CI，11% - 19%）。临床诊断干眼症和严重症状的综合终点结果相似。
这些数据表明，使用HRT的女性，尤其是单独使用雌激素的女性，患干眼症的风险增加。照顾正在服用或考虑使用HRT的女性的医生应了解这种潜在并发症。
