Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
J Neurointerv Surg. 2011 Jun;3(2):163-6. doi: 10.1136/jnis.2010.003855. Epub 2010 Dec 17.
It is well known that cerebral aneurysms occur more frequently in women, with numerous studies suggesting a role for hormones in aneurysm pathogenesis. Estrogen promotes normal physiologic vascular endothelial function but also fluctuates during the menstrual cycle and drops significantly at menopause.
A retrospective, case control study was conducted to determine if exogenous estrogen use, which stabilizes estradiol levels, had any association with the presence of cerebral aneurysms. 60 women with intradural cerebral aneurysms were interviewed about their basic medical and female reproductive health histories, including oral contraceptive pill and hormone replacement therapy use and duration of use. This information was compared with the same data collected from women in the general public, as represented by 4682 women contacted through random digit phone dialing in the National Institute of Child Health and Human Development sponsored Contraceptive and Reproductive Experiences Study, published in 2002.
Multivariate logistic regression showed a significant association between a lower rate of oral contraceptive (OR 2.1, CI 1.17 to 3.81; p=0.01) and hormone replacement therapy (OR 3.09, CI 1.54 to 6.22; p=0.002) use and the presence of a cerebral aneurysm.
These data suggest that exposure to exogenous estrogen agents in women is associated with a lower frequency of cerebral aneurysms.
众所周知，女性更容易发生脑动脉瘤，许多研究表明激素在动脉瘤发病机制中起作用。雌激素促进正常的血管内皮功能，但在月经周期中波动，在绝经期显著下降。
进行了一项回顾性病例对照研究，以确定外源性雌激素的使用是否与脑动脉瘤的存在有关，外源性雌激素可以稳定雌二醇水平。对 60 名患有颅内脑动脉瘤的女性进行了关于其基本医疗和女性生殖健康史的访谈，包括口服避孕药和激素替代疗法的使用及其使用持续时间。该信息与通过国家儿童健康与人类发展研究所赞助的避孕药具和生殖经历研究，于 2002 年发表的在普通人群中随机抽取的 4682 名女性收集到的相同数据进行了比较。
多变量逻辑回归显示，口服避孕药（OR 2.1，CI 1.17 至 3.81；p=0.01）和激素替代疗法（OR 3.09，CI 1.54 至 6.22；p=0.002）使用的降低与脑动脉瘤的存在显著相关。
这些数据表明，女性接触外源性雌激素药物与脑动脉瘤的发生频率较低有关。
