Cano A, Fernandes H, Serrano S, Mahiques P
Department of Obstetrics and Gynaecology, Facultad de Medicina, Universidad de Valencia, Spain.
Maturitas. 1991 Mar;13(1):35-42. doi: 10.1016/0378-5122(91)90283-v.
Plasma lipids and lipoproteins were measured in 21 post-menopausal women after 4 and 8 months of continuous treatment with an orally administered combination of oestradiol and medroxyprogesterone acetate. The mean concentrations of cholesterol and low-density-lipoprotein (LDL) cholesterol were reduced by 12% (P less than 0.001) and 11% (P less than 0.01), respectively, after 4 months of treatment and by 9% (P less than 0.05) and 12% (P less than 0.05) after 8 months. The mean level of high-density-lipoprotein (HDL) cholesterol showed an initial fall of 5% (P less than 0.05) after 4 months and then increased by 13% (P less than 0.05) after 8 months of treatment. The plasma triglycerides level oscillated around the baseline value, but the changes were not statistically significant. Indexes such as the HDL-cholesterol/LDL-cholesterol and cholesterol/HDL-cholesterol ratios, which are considered to be good indicators of atherogenic risk, showed changes towards patterns considered to be beneficial. Although the clinical significance of these changes remains uncertain at present, it seems clear that an oestradiol and medroxyprogesterone combination administered continuously produces biochemical changes which are regarded as protective against cardiovascular disease. Additionally, the endometrial inertness attributed to the continuous oestrogen-progestogen therapy would warrant its use as a good alternative in post-menopausal replacement therapy.
对21名绝经后女性连续4个月和8个月口服雌二醇与醋酸甲羟孕酮联合制剂进行治疗,之后测定其血浆脂质和脂蛋白水平。治疗4个月后,胆固醇和低密度脂蛋白(LDL)胆固醇的平均浓度分别降低了12%(P<0.001)和11%(P<0.01),治疗8个月后分别降低了9%(P<0.05)和12%(P<0.05)。高密度脂蛋白(HDL)胆固醇的平均水平在治疗4个月后最初下降了5%(P<0.05),但在治疗8个月后升高了13%(P<0.05)。血浆甘油三酯水平在基线值附近波动,但变化无统计学意义。诸如HDL胆固醇/LDL胆固醇和胆固醇/HDL胆固醇比值等被认为是动脉粥样硬化风险良好指标的指数显示,变化趋势朝着有益的模式发展。虽然目前这些变化的临床意义仍不确定,但连续给予雌二醇和甲羟孕酮联合制剂似乎显然会产生被认为对心血管疾病有保护作用的生化变化。此外,连续雌激素 - 孕激素疗法所致的子宫内膜惰性使其有理由成为绝经后替代疗法的良好选择。