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[绝经后女性口服地屈孕酮或甲羟孕酮联合持续经皮补充17β-雌二醇12个月期间的总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇血浆水平]

[Plasma levels of total cholesterol, LDL-cholesterol, and HDL-cholesterol in postmenopausal women during 12 months' oral administration of dydrogesterone or medroxyprogesterone combined with continuous transdermal supplementation of 17beta-estradiol].

作者信息

Milewicz Tomasz, Kostecka Anna, Rogatko Iwona, Sztefko Krystyna, Kwiatkowska-Panek Ewa, Radowick Stanisław, Krzysiek Józef

机构信息

Klinika Endokrynologii Ginekologicznej Collegium Medicum, Uniwersytetu Jagiellońtskiego w Krakowie.

出版信息

Przegl Lek. 2007;64(2):65-9.

Abstract

AIM

To compare the effect on total cholesterol and LDL and HDL cholesterol of oral dydrogesterone and medroxyprogesterone administration combined with continuous transdermal supplementation of 17beta-estradiol in postmenopausal women. MATERIAL & METHODS. The prospective study was carried out in 59 healthy postmenopausal women (mean age 54.5 +/- 3.34 years). They were randomized and treated either with continuous transdermal hormonal therapy (HT) (Group A; n=25; 17beta-estradiol at a dose of 0.05 mg/24 hours combined with oral dydrogesterone at a daily dose of 5 mg or group B, n=24; 17beta-estradiol at a dose of 0.05 mg/24 hours combined with oral medroxyprogesterone at a daily dose of 5 mg) or observed as a control group C (n=10). Basal plasma levels of total cholesterol, HDL-cholesterol and LDL-cholesterol as well as basal estrogen and FSH levels were measured before HT and after 6 and 12 months of treatment. At the same time intervals, all the studied parameters were measured for group C.

RESULTS

After 6 months of continuous transdermal supplementation of 17beta-estradiol with oral dydrogesterone the plasma level of total cholesterol decreased (6.23 +/- 1.02 mmol/l vs 5.65 +/- 0.96 mmol/l; p < 0.05). The effect was also maintained after 12 months of HT (5.46 +/- 1.0 mmol/l). The plasma level of LDL-cholesterol was also decreased after 6 months of HT (3.87 +/- 0.83 mmol/ I vs 3.42 +/- 0.58 mmol/l; p < 0.05). The effect was also maintained after 12 months of HT (3.48 +/- 0.73 mmol/l). HDL-cholesterol plasma level was increased after 6 months of HT (1.52 +/- 0.45 mmol/l vs 1.76 +/- 0.45 mmol/l; p < 0.05) and was maintained after 12 months. The beneficial changes of plasma levels of total cholesterol, HDL-cholesterol and LDL-cholesterol in group B did not reach the statistical significance. The lipid and lipoproteins mean plasma levels remained unchanged in the control group during 12 months of observation.

CONCLUSION

Adding dydrogestrone or medroxyprogesterone to the continuous transdermal supplementation of 17beta-estradiol did not deteriorate the modificable atherosclerotic risk factors.

摘要

目的

比较口服地屈孕酮和甲羟孕酮联合持续经皮补充17β-雌二醇对绝经后女性总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇的影响。材料与方法。对59名健康绝经后女性(平均年龄54.5±3.34岁)进行了前瞻性研究。她们被随机分组并接受以下治疗:持续经皮激素治疗(HT)(A组;n = 25;17β-雌二醇剂量为0.05 mg/24小时,联合口服地屈孕酮,每日剂量5 mg;或B组,n = 24;17β-雌二醇剂量为0.05 mg/24小时,联合口服甲羟孕酮,每日剂量5 mg),或作为对照组C(n = 10)进行观察。在HT治疗前以及治疗6个月和12个月后,测量总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇的基础血浆水平,以及基础雌激素和促卵泡激素水平。在相同时间间隔,对C组测量所有研究参数。

结果

17β-雌二醇与口服地屈孕酮持续经皮补充6个月后,总胆固醇血浆水平下降(6.23±1.02 mmol/L对5.65±0.96 mmol/L;p < 0.05)。HT治疗12个月后该效果也得以维持(5.46±1.0 mmol/L)。HT治疗6个月后,低密度脂蛋白胆固醇血浆水平也下降(3.87±0.83 mmol/L对3.42±0.58 mmol/L;p < 0.05)。HT治疗12个月后该效果也得以维持(3.48±0.73 mmol/L)。HT治疗6个月后,高密度脂蛋白胆固醇血浆水平升高(1.52±0.45 mmol/L对1.76±0.45 mmol/L;p < 0.05),并在12个月后得以维持。B组总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇血浆水平的有益变化未达到统计学意义。在12个月的观察期内,对照组的脂质和脂蛋白平均血浆水平保持不变。

结论

在持续经皮补充17β-雌二醇的基础上添加地屈孕酮或甲羟孕酮不会使可改变的动脉粥样硬化危险因素恶化。

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