Peverill Roger E
Cardiology Unit, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia.
Best Pract Res Clin Endocrinol Metab. 2003 Mar;17(1):149-64. doi: 10.1016/s1521-690x(02)00079-9.
Convincing data from randomized trials and observational studies have demonstrated a two- to threefold increased risk of venous thromboembolism (VTE) with the use of hormone replacement therapy (HRT) in post-menopausal women. This risk is highest in the first year of use, but an increased risk persists after the first year if HRT use is ongoing. The risk of VTE is increased for oral oestrogen alone, oral oestrogen combined with progestin and probably for transdermal HRT. There is an increase in both idiopathic and non-idiopathic VTE with HRT. Early evidence suggests an interaction of HRT with thrombophilic states such as the factor V Leiden mutation, resulting in a synergistic increase in the risk of VTE. There is also an increased risk of VTE with raloxifene and tamoxifen, but the effects of low-dose HRT and tibolone on VTE risk are less clear.
来自随机试验和观察性研究的令人信服的数据表明，绝经后女性使用激素替代疗法（HRT）会使静脉血栓栓塞（VTE）风险增加两到三倍。这种风险在使用的第一年最高，但如果持续使用HRT，第一年之后风险仍会持续增加。单独使用口服雌激素、口服雌激素联合孕激素以及经皮HRT可能都会增加VTE风险。HRT会使特发性和非特发性VTE均增加。早期证据表明，HRT与诸如因子V Leiden突变等血栓形成倾向状态相互作用，导致VTE风险协同增加。雷洛昔芬和他莫昔芬也会增加VTE风险，但低剂量HRT和替勃龙对VTE风险的影响尚不清楚。
