Naessen Tord, Rodriguez-Macias Kenny
Department of Women's and Children's Health, Section for Obstetrics and Gynecology, University Hospital, SE-751 85 Uppsala, Sweden.
Atherosclerosis. 2006 Dec;189(2):387-92. doi: 10.1016/j.atherosclerosis.2005.12.023. Epub 2006 Feb 7.
Estrogen therapy that is started at the time of menopause seems to protect against the development of atherosclerosis and cardiovascular diseases, in contrast to the initial increased cardiovascular risk when hormone therapy is initiated in older women. With increased aging and degree of atherosclerosis, the thickness of the artery intima increases and that of the media decreases. These changes can be noninvasively estimated using high-frequency ultrasound.
The thickness of carotid and femoral artery intima and media was assessed, using noninvasive high-frequency ultrasound (25MHz). Long-term estrogen users (mean treatment duration 20 years) had a significantly thinner mean carotid intima layer (-25%; P=0.0002), a thicker media layer (+74%; P=0.0002) and a substantially lower intima/media thickness ratio (-54%; P<0.0001) than 17 age-matched nonusers, with values closer to those in 20 premenopausal women. Similar but less pronounced differences between the postmenopausal groups were found for the femoral artery.
A preserved thin artery wall intima and a low intima/media thickness ratio, at values close to those in young women might be partially responsible for the beneficial cardiovascular effects of estrogen therapy when it is initiated at the time of menopause.
与在老年女性中开始激素治疗时最初心血管风险增加相反，在绝经时开始的雌激素治疗似乎可预防动脉粥样硬化和心血管疾病的发生。随着年龄增长和动脉粥样硬化程度增加，动脉内膜厚度增加而中膜厚度减小。这些变化可用高频超声进行无创评估。
使用无创高频超声（25MHz）评估颈动脉和股动脉内膜及中膜厚度。长期使用雌激素者（平均治疗持续时间20年）与17名年龄匹配的未使用者相比，平均颈动脉内膜层明显更薄（-25%；P=0.0002），中膜层更厚（+74%；P=0.0002），内膜/中膜厚度比显著更低（-54%；P<0.0001），其数值更接近20名绝经前女性。在股动脉方面，绝经后组之间也发现了类似但不太明显的差异。
当在绝经时开始雌激素治疗时，保留的薄动脉壁内膜和低内膜/中膜厚度比（数值接近年轻女性）可能部分解释了雌激素治疗对心血管有益的作用。
