Forabosco A, Criscuolo M, Coukos G, Uccelli E, Weinstein R, Spinato S, Botticelli A, Volpe A
Department of Dentistry, University of Modena, Italy.
Oral Surg Oral Med Oral Pathol. 1992 May;73(5):570-4. doi: 10.1016/0030-4220(92)90100-5.
The increase in incidence of oral discomfort among women in a menopause is probably due to hormone modifications. This study evaluated the efficacy of hormone replacement therapy in 27 postmenopausal patients, aged 48 to 58 years, with oral discomfort and no local irritants and in 47 postmenopausal women with no oral discomfort. Patients were treated with conjugated estrogens for 21 days and medroxyprogesterone acetate from day 12 through day 21. Hormone-replacement therapy had no effect on oral cytology in the 40 symptom-free postmenopausal women compared with a group of 47 postmenopausal women who had no oral symptoms and were not treated. Hormone-replacement therapy relieved symptoms and improved oral cytohormonal features in 15 of 27 patients with symptoms. Nuclear estrogen receptors were found by immunohistochemical assay in 8 of 10 randomly selected patients with symptoms who responded to hormone-replacement therapy, but not in 2 patients who did not benefit from hormone-replacement therapy. Estrogen receptors were also found in 6 of 10 fertile women with no oral disease. Our results suggest that oral discomfort may be related to steroid hormone withdrawal only in some postmenopausal women and that replacement therapy may improve the clinical picture and cytologic features in this group of patients. Immunohistochemical identification of estrogen receptors may help to identify patients for whom hormone-replacement therapy may be beneficial.
更年期女性口腔不适发生率的增加可能归因于激素变化。本研究评估了激素替代疗法对27名年龄在48至58岁、有口腔不适且无局部刺激因素的绝经后患者以及47名无口腔不适的绝经后女性的疗效。患者接受共轭雌激素治疗21天，从第12天至第21天加用醋酸甲羟孕酮。与47名无口腔症状且未接受治疗的绝经后女性相比，激素替代疗法对40名无症状绝经后女性的口腔细胞学没有影响。激素替代疗法使27名有症状患者中的15名症状得到缓解，并改善了口腔细胞激素特征。通过免疫组织化学分析，在随机选择的10名对激素替代疗法有反应的有症状患者中，有8名发现了核雌激素受体，而在2名未从激素替代疗法中获益的患者中未发现。在10名无口腔疾病的育龄女性中，也有6名发现了雌激素受体。我们的结果表明，口腔不适可能仅在某些绝经后女性中与类固醇激素撤退有关，替代疗法可能改善这组患者的临床表现和细胞学特征。雌激素受体的免疫组织化学鉴定可能有助于识别可能从激素替代疗法中获益的患者。
