Henderson B E, Ross R K, Lobo R A, Pike M C, Mack T M
University of Southern California School of Medicine, Los Angeles.
Fertil Steril. 1988 May;49(5 Suppl 2):9S-15S.
An estrogen-progestogen regimen of hormone replacement therapy has become widely used in recent years, primarily as a means to protect the endometrium from the carcinogenic effects of unopposed estrogen therapy (ERT). In this article, we evaluate the probable effects of this regimen on mortality from endometrial cancer as well as mortality from other chronic diseases. We conclude from this analysis that ERT is to be preferred to combination therapy for postmenopausal women without a uterus, primarily because it is predicted that ERT confers a significantly greater benefit on heart disease risk. In women with a uterus, if progestogens are to be prescribed, they should be given in the lowest possible dose needed to achieve the desired histologic changes in the endometrium, since the predicted loss in heart disease benefit from adding the progestogen is substantial.
近年来，雌激素 - 孕激素联合的激素替代疗法已被广泛应用，主要作为一种保护子宫内膜免受单纯雌激素疗法（ERT）致癌作用的手段。在本文中，我们评估了该疗法对子宫内膜癌死亡率以及其他慢性疾病死亡率的可能影响。我们从该分析中得出结论，对于没有子宫的绝经后女性，ERT优于联合疗法，主要是因为预计ERT对心脏病风险的益处显著更大。对于有子宫的女性，如果要开孕激素处方，应以实现子宫内膜所需组织学变化所需的最低可能剂量给药，因为预计添加孕激素会使心脏病益处大幅降低。
