Staren Edgar D, Omer Shuab
Department of Surgery, Medical College of Ohio, 3065 Arlington Ave., Toledo, OH 43614-5807, USA.
Am J Surg. 2004 Aug;188(2):136-49. doi: 10.1016/j.amjsurg.2003.12.063.
For many years, hormone replacement therapy (HRT) was considered an effective method of restoring the relative protection from coronary artery disease enjoyed by premenopausal women compared with men of similar age. This view has been supported by a substantial number of basic science and observational studies.
Results of recent randomized controlled trials have seriously challenged the concept of the protective value of HRT by showing that rather than decreasing the risk of coronary artery disease, HRT actually appears to increase it. In addition, it increases the risk for breast cancer, stroke, venous thromboembolism, and cholecystitis.
Despite some benefits such as increased bone mineral density and decreased risk of fracture and colorectal cancer, these data suggest that the risks of HRT outweigh the benefits.
HRT is no longer routinely recommended for prevention of chronic disease. We present the current scientific data, benefits, risks, and consequent clinical recommendations regarding HRT use in postmenopausal women.
多年来，激素替代疗法（HRT）被认为是一种有效的方法，可恢复绝经前女性相较于同龄男性所享有的对冠状动脉疾病的相对保护作用。这一观点得到了大量基础科学和观察性研究的支持。
近期随机对照试验的结果严重挑战了HRT具有保护作用这一概念，表明HRT非但没有降低冠状动脉疾病风险，实际上似乎还会增加该风险。此外，它还会增加患乳腺癌、中风、静脉血栓栓塞和胆囊炎的风险。
尽管HRT有一些益处，如增加骨矿物质密度、降低骨折和结直肠癌风险，但这些数据表明，HRT的风险超过了益处。
不再常规推荐HRT用于预防慢性病。我们展示了关于绝经后女性使用HRT的当前科学数据、益处、风险及相应的临床建议。
