Ozsener S, Sendag F, Koc T, Terek M C, Oztekin K, Bilgin O
Department of Obstetrics and Gynecology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
J Obstet Gynaecol Res. 2001 Dec;27(6):353-8. doi: 10.1111/j.1447-0756.2001.tb01285.x.
To compare the lipid-altering effects of hormone replacement therapy alone and in combination with HMG-CoA reductase inhibitor in postmenopausal women with hypercholesterolemia.
This was a prospective randomized controlled trial with 3 parallel groups. The patients (n = 35) were randomly assigned to receive pravastatin 20 mg/day (n = 12); continuous combined hormone replacement therapy (0.625 mg conjugated estrogen/day combined with medroxyprogesterone 5 mg/day) (n = 12); continuous combined hormone replacement therapy plus pravastatin (n = 11) for 16 weeks.
Among patients treated with continuous combined hormone replacement therapy levels of total cholesterol (10.7%) and LDL cholesterol (12.6%) decreased significantly (p < 0.05), while levels of high density lipoprotein cholesterol (5%) and triglycerides (6.2%) increased insignificantly (p > 0.05). Patients in the pravastatin group achieved significant reductions of 18.8 and 21.4% in total cholesterol and low density lipoprotein cholesterol levels, respectively (p < 0.05). Among patients treated with a combination of continuous combined hormone replacement therapy plus pravastatin, levels of total cholesterol (20.5%) and low density lipoprotein cholesterol (23.8%) decreased the most, while levels of triglycerides (2.1%) decreased lower than the pravastatin-only group. The mean percentage of the differences between the baseline and treatment levels of the lipids and lipoproteins were not significant between the 3 study groups (p > 0.05).
No significant difference between hormone replacement therapy alone and in combination with HMG-CoA reductase inhibitor in the treatment of postmenopausal women with hypercholesterolemia was noted in this study. The combination of hormone replacement therapy not only does not adversely affect the lipid-lowering effect of pravastatin alone, but hormone replacement therapy also offers additional benefits in the treatment of hypoestrogenic hypercholesterolemia in postmenopausal women.
比较单独使用激素替代疗法以及联合HMG-CoA还原酶抑制剂对绝经后高胆固醇血症女性的脂质改变作用。
这是一项前瞻性随机对照试验，设有3个平行组。患者（n = 35）被随机分配接受以下治疗：普伐他汀20毫克/天（n = 12）；连续联合激素替代疗法（结合雌激素0.625毫克/天联合甲羟孕酮5毫克/天）（n = 12）；连续联合激素替代疗法加普伐他汀（n = 11），为期16周。
接受连续联合激素替代疗法的患者中，总胆固醇水平（降低10.7%）和低密度脂蛋白胆固醇水平（降低12.6%）显著下降（p < 0.05），而高密度脂蛋白胆固醇水平（升高5%）和甘油三酯水平（升高6.2%）升高不显著（p > 0.05）。普伐他汀组患者的总胆固醇和低密度脂蛋白胆固醇水平分别显著降低了18.8%和21.4%（p < 0.05）。在接受连续联合激素替代疗法加普伐他汀联合治疗的患者中，总胆固醇水平（降低20.5%）和低密度脂蛋白胆固醇水平（降低23.8%）下降最多，而甘油三酯水平（降低2.1%）下降幅度低于仅使用普伐他汀的组。3个研究组之间脂质和脂蛋白基线水平与治疗水平差异的平均百分比无显著差异（p > 0.05）。
本研究未发现单独使用激素替代疗法与联合HMG-CoA还原酶抑制剂治疗绝经后高胆固醇血症女性之间存在显著差异。激素替代疗法联合使用不仅不会对普伐他汀单独的降脂效果产生不利影响，而且激素替代疗法在治疗绝经后女性低雌激素性高胆固醇血症方面还具有额外益处。
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