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激素替代疗法对绝经后女性认知功能的影响:一项随机对照试验。

The effect of hormone replacement therapy on cognitive function in postmenopausal women: An RCT.

作者信息

Moradi Fereshteh, Jahanian Sadatmahalleh Shahideh, Ziaei Saeideh

机构信息

Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

出版信息

Int J Reprod Biomed. 2019 Jan 28;16(12). doi: 10.18502/ijrm.v16i12.3682. eCollection 2018 Dec.

Abstract

BACKGROUND

During the reproductive age, the human brain becomes a target for gonadal steroid hormones. Estrogens influence neural function through effects on neurons and affects indirectly the oxidative stress, inflammation, the cerebral vascular and the immune system.

OBJECTIVE

To evaluate the effect of the traditional hormone replacement therapy (HRT) on the cognitive function in postmenopausal women.

MATERIALS AND METHODS

In this randomized clinical trial, 140 postmenopausal women, from November 2014 to February 2015, were included. Women were randomly divided into two groups. Each woman in the case group took traditional HRT (0.625mg conjugated equine estrogens+2.5mg medroxyprogesterone acetate daily) plus one Cal+D tablet (500 mg calcium+200 IU vitamin D) daily for four months. Women in the control group received only one Cal+D tablet (500 mg calcium+200 IU vitamin D) daily for four months period. The Montreal Cognitive Assessment (MoCA) and Green Climacteric Scale (GCS) questionnaires filled out after the intervention and compared between the two groups.

RESULTS

The mean points of the MoCA after the intervention indicate that all MoCA domains except for the orientation improved in the case group. There was a significant difference in the memory domain after the treatment between the two groups. MoCA domains and GCS were negatively correlated after the intervention ( ).

CONCLUSION

The HRT has affected some of the MoCA factors. The effects of HRT on cognitive function should be studied in a large prospective study in a group of women in their early and late menopausal ages with periodic assessment of their cognitive function during these follow-up years.

摘要

背景

在生育年龄期间,人类大脑成为性腺甾体激素的作用靶点。雌激素通过对神经元的作用影响神经功能,并间接影响氧化应激、炎症、脑血管和免疫系统。

目的

评估传统激素替代疗法(HRT)对绝经后女性认知功能的影响。

材料与方法

在这项随机临床试验中,纳入了2014年11月至2015年2月期间的140名绝经后女性。将女性随机分为两组。病例组的每位女性每天服用传统HRT(0.625mg结合马雌激素+2.5mg醋酸甲羟孕酮)加一片钙加D片(500mg钙+200IU维生素D),持续四个月。对照组的女性在四个月期间仅每天服用一片钙加D片(500mg钙+200IU维生素D)。干预后填写蒙特利尔认知评估(MoCA)和绿色更年期量表(GCS)问卷,并在两组之间进行比较。

结果

干预后MoCA的平均得分表明,病例组除定向外的所有MoCA领域均有所改善。两组治疗后记忆领域存在显著差异。干预后MoCA领域与GCS呈负相关( )。

结论

HRT影响了一些MoCA因素。应在一项大型前瞻性研究中,对一组处于绝经早期和晚期的女性进行研究,在这些随访年份中定期评估她们的认知功能,以研究HRT对认知功能的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d009/6600282/31bb70e8f513/ijrb-16-767-g001.jpg

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