常规剂量或低剂量激素替代疗法对绝经后女性的影响。

Effects of conventional or lower doses of hormone replacement therapy in postmenopausal women.

作者信息

Koh Kwang Kon, Shin Mi-Seung, Sakuma Ichiro, Ahn Jeong Yeal, Jin Dong Kyu, Kim Hyung Sik, Kim Dae Sung, Han Seung Hwan, Chung Wook-Jin, Shin Eak Kyun

机构信息

Department of Cardiology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

出版信息

Arterioscler Thromb Vasc Biol. 2004 Aug;24(8):1516-21. doi: 10.1161/01.ATV.0000133683.65877.bc. Epub 2004 May 27.

DOI:10.1161/01.ATV.0000133683.65877.bc

PMID:15166013

Abstract

OBJECTIVE

The effects of hormone replacement therapy (HRT) can affect many aspects relevant to cardiovascular disease, including vasomotor function, inflammation, and hemostasis. Recent studies have demonstrated that current doses of HRT exert a mixture of both protective and adverse effects. In the current study, we compared the effects of lower doses of HRT (L-HRT) and conventional doses of HRT (C-HRT) on a variety of relevant cardiovascular parameters.

METHODS AND RESULTS

This randomized, double-blind, crossover study included 57 women who received micronized progesterone 100 mg with either conjugated equine estrogen 0.625 mg (C-HRT) or 0.3 mg (L-HRT) daily for 2 months. L-HRT showed comparable effects to C-HRT on high-density lipoprotein cholesterol and triglyceride levels, but not on low-density lipoprotein cholesterol levels. C-HRT and L-HRT significantly improved the percent flow-mediated dilator response to hyperemia from baseline values (both P<0.001) by a similar degree (P=0.719). C-HRT significantly increased high-sensitivity C-reactive protein (hsCRP) levels from baseline values (P<0.001); however, L-HRT did not significantly change hsCRP (P=0.874). C-HRT and L-HRT significantly decreased antithrombin III from baseline values (P<0.001 and P=0.042, respectively). C-HRT significantly increased prothrombin fragment 1+2 (F1+2) from baseline values (P<0.001); however, L-HRT did not significantly change F1+2 (P=0.558). Of interest, the effects of C-HRT and L-HRT on hsCRP, antithrombin III, and F1+2 were significantly different (all P<0.001). C-HRT and L-HRT significantly reduced plasma PAI-1 antigen levels from baseline values (P=0.002 and P=0.038, respectively) to a similar degree (P=0.184).

CONCLUSIONS

Compared with C-HRT, L-HRT has comparable effects on lipoproteins, flow-mediated dilation, and PAI-1 antigen levels. However, L-HRT did not increase hsCRP or F1+2 levels, and it decreased antithrombin III less than C-HRT.

摘要

目的

激素替代疗法（HRT）的效果会影响与心血管疾病相关的多个方面，包括血管舒缩功能、炎症和止血。近期研究表明，当前剂量的HRT既有保护作用，也有不良影响。在本研究中，我们比较了低剂量HRT（L-HRT）和传统剂量HRT（C-HRT）对各种相关心血管参数的影响。

方法与结果

这项随机、双盲、交叉研究纳入了57名女性，她们每天接受100毫克微粒化孕酮，同时分别服用0.625毫克共轭马雌激素（C-HRT）或0.3毫克（L-HRT），持续2个月。L-HRT在高密度脂蛋白胆固醇和甘油三酯水平上显示出与C-HRT相当的效果，但在低密度脂蛋白胆固醇水平上则不然。C-HRT和L-HRT均使血流介导的充血扩张反应百分比从基线值显著改善（均P<0.001），改善程度相似（P=0.719）。C-HRT使高敏C反应蛋白（hsCRP）水平从基线值显著升高（P<0.001）；然而，L-HRT并未使hsCRP显著改变（P=0.874）。C-HRT和L-HRT均使抗凝血酶III从基线值显著降低（分别为P<0.001和P=0.042）。C-HRT使凝血酶原片段1+2（F1+2）从基线值显著升高（P<0.001）；然而，L-HRT并未使F1+2显著改变（P=0.558）。有趣的是，C-HRT和L-HRT对hsCRP、抗凝血酶III和F1+2的影响存在显著差异（均P<0.001）。C-HRT和L-HRT均使血浆纤溶酶原激活物抑制剂-1抗原水平从基线值显著降低（分别为P=0.002和P=0.038），降低程度相似（P=0.184）。