Department of Reproductive Medicine and Child Development, Division of Obstetrics and Gynecology Piero Fioretti, Pisa University Hospital, University of Pisa, Via Roma 67, Pisa, Italy.
Climacteric. 2011 Feb;14(1):18-24. doi: 10.3109/13697137.2010.520099. Epub 2010 Oct 27.
To describe the effects of low-dose hormonal replacement therapy (HRT) on quality of life, metabolic parameters and blood pressure in postmenopausal women.
Postmenopausal women untreated with HRT or sex steroids in the previous 12 months were randomized to treatment with 17β-estradiol (1 mg/day) plus drospirenone (2 mg/day) (E2+DRSP) or to calcium (controls). Quality of life was evaluated by the Women's Health Questionnaire (WHQ) at baseline and after 6 and 12 weeks of treatment. Anthropometric, metabolic and blood pressure measurements were performed before and after 3 months of treatment.
WHQ domain scores for vasomotor and somatic symptoms, anxiety/fears, depressed mood, sexual behavior and sleep problems decreased significantly in the E2+DRSP group relative to both baseline and control values (p < 0.05). Body mass index was unchanged, while waist circumference decreased significantly (p < 0.001) after E2+DRSP treatment. Significant decreases were also observed after E2+DRSP treatment for blood insulin values, insulin resistance (estimated by homeostasis model assessment) and systolic blood pressure (p < 0.001, all). In subjects with systolic blood pressure < 130 mmHg at baseline, no changes in systolic values were registered, while women with baseline high-normal systolic blood pressure (130-139 mmHg) showed significant decreases (p < 0.0069). E2+DRSP did not modify diastolic blood pressure values. In the calcium-treatment group, there were no significant changes in WHQ scores or in anthropometric, metabolic or blood pressure measurements.
In postmenopausal women, E2+DRSP administration improves vasomotor symptoms and general aspects of quality of life and may positively influence cardiovascular risk factors.
描述小剂量激素替代疗法（HRT）对绝经后妇女生活质量、代谢参数和血压的影响。
未接受 HRT 或性激素治疗的绝经后妇女，随机分为雌二醇 17β（1mg/天）加屈螺酮（2mg/天）（E2+DRSP）治疗组或钙治疗组（对照组）。治疗前和治疗 3 个月后分别进行生活质量评估（WHQ），采用 WHQ 评估血管舒缩和躯体症状、焦虑/恐惧、抑郁情绪、性行为和睡眠问题。治疗 6 和 12 周后，分别记录 WHQ 评分。治疗前和治疗 3 个月后分别测量人体测量学、代谢和血压。
与基线和对照组相比，E2+DRSP 组血管舒缩和躯体症状、焦虑/恐惧、抑郁情绪、性行为和睡眠问题的 WHQ 域评分显著降低（p<0.05）。E2+DRSP 治疗后，体重指数保持不变，而腰围显著减小（p<0.001）。E2+DRSP 治疗后，血胰岛素值、胰岛素抵抗（用稳态模型评估）和收缩压也显著降低（p<0.001，均）。在基线收缩压<130mmHg 的患者中，收缩压无变化，而基线高正常收缩压（130-139mmHg）的患者收缩压显著降低（p<0.0069）。E2+DRSP 未改变舒张压值。在钙治疗组，WHQ 评分或人体测量学、代谢或血压测量均无显著变化。
在绝经后妇女中，E2+DRSP 治疗可改善血管舒缩症状和整体生活质量，并可能对心血管危险因素产生积极影响。
