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围绝经期和绝经后患有动脉高血压的女性的激素替代疗法:血流动力学效应

[Hormone replacement therapy in women with arterial hypertension in peri- and postmenopause: hemodynamic effects].

作者信息

Bystrova M M, Britov A N, Gorbunov V M, Lebedev A V, Eliseeva N A, Smetnik V P, Slasten O P

出版信息

Ter Arkh. 2001;73(10):33-8.

Abstract

AIM

To study hemodynamic effects of replacement hormone therapy (RHT) with trisecvens, beta-blocker betaksolol and their combination in perimenopausal and menopausal women with hypertension.

MATERIAL AND METHODS

The study was made of 60 menopausal women aged 45-60 with mild and moderate arterial hypertension (AH). The women had no contraindications to either RHT or beta-blockers. They were randomized into three groups: group 1 received trisekvens, group 2--trisekvens plus betaksolol in a dose 10-20 mg/day, group 3--betaksolol. Arterial pressure (AP) and heart rate (HR) were measured before the treatment, in one month and each three months for a year. ECG and echo-CG were registered before treatment and each 3 months of the therapy. AP monitoring covered 50% of the patients of each group before the treatment and after 1 and 3 months of it. The data were analysed according to SAS system.

RESULTS

Group 1 patients showed no significant changes in AP and HR. Group 2 and 3 patients' AP lowered, in group 2 the fall of systolic AP being more pronounced. 12-month therapy brought about a 10.3% decrease in left ventricular myocardial mass index in group 2.

CONCLUSION

RHT with trisekvens in combination with beta-blocker in long-term use potentiates the effect on systolic AP and reduced hypertrophy of the left ventricle. RHT does not produce a significant effect on AP in women with AH recorded before the menopause.

摘要

目的

研究替勃龙、β受体阻滞剂倍他洛尔及其联合应用对围绝经期和绝经后高血压女性进行替代激素治疗(RHT)时的血流动力学影响。

材料与方法

本研究纳入了60名年龄在45 - 60岁的绝经后轻度和中度动脉高血压(AH)女性。这些女性对RHT或β受体阻滞剂均无禁忌证。她们被随机分为三组:第1组接受替勃龙,第2组接受替勃龙加剂量为10 - 20毫克/天的倍他洛尔,第3组接受倍他洛尔。在治疗前、治疗1个月时以及之后每3个月测量一次动脉血压(AP)和心率(HR),为期一年。在治疗前以及治疗的每3个月记录一次心电图(ECG)和超声心动图(echo - CG)。在治疗前以及治疗1个月和3个月后,对每组50%的患者进行AP监测。数据采用SAS系统进行分析。

结果

第1组患者的AP和HR无显著变化。第2组和第3组患者的AP降低,第2组收缩压AP下降更为明显。12个月的治疗使第2组左心室心肌质量指数下降了10.3%。

结论

长期联合使用替勃龙与β受体阻滞剂进行RHT可增强对收缩压AP的影响,并减轻左心室肥厚。RHT对绝经前记录有AH的女性的AP没有显著影响。

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