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卵巢切除术后女性接受合成雌激素治疗后的代谢、激素及血管变化。

Metabolic, hormonal, and vascular changes after synthetic oestrogen therapy in oophorectomized women.

作者信息

MacGillivray I, Gow S

出版信息

Br Med J. 1971 Apr 10;2(5753):73-7. doi: 10.1136/bmj.2.5753.73.

Abstract

Mestranol, the three-methyl ether form of ethinyloestradiol and one of the two oestrogens used in oral contraceptive steroids, was administered in a dose of 0.02 mg daily for 120 days to 25 oophorectomized women.Urinary oestriol and pregnanediol excretions were unaffected by the mestranol treatment but there was a shift of the maturation index of the vaginal smear to the right, indicating a correction of the pretreatment oestrogen deficiency. No significant change in the blood pressure or electrocardiograph recordings occurred during this relatively short period of administration. A significant rise in the serum protein-bound iodine, which might be regarded as an undesirable effect of mestranol on a long-term basis, occurred. Hepatic function as measured by bromsulphthalein was not impaired by the treatment. Mestranol had no effect on the total body water or on the total exchangeable potassium of the women. Its two most serious adverse effects were impairment of glucose tolerance and a high incidence (16%) of venous thrombo-embolic disease.The gravity of the adverse effects far outweighs any beneficial ones and precludes the use of mestranol alone for long-term hormone replacement therapy in postmenopausal women.

摘要

炔雌醇甲醚是炔雌醇的三甲醚形式,是口服避孕甾体激素中使用的两种雌激素之一,对25名卵巢切除的女性每天给予0.02毫克的剂量,持续120天。炔雌醇甲醚治疗对尿雌三醇和孕二醇的排泄没有影响,但阴道涂片的成熟指数向右偏移,表明治疗前雌激素缺乏得到纠正。在这段相对较短的给药期间,血压和心电图记录没有显著变化。血清蛋白结合碘显著升高,从长期来看,这可能被视为炔雌醇甲醚的不良影响。通过酚四溴酞磺酸钠测量的肝功能没有受到该治疗的损害。炔雌醇甲醚对女性的总体液或总可交换钾没有影响。它最严重的两个不良反应是糖耐量受损和静脉血栓栓塞疾病的高发生率(16%)。这些不良反应的严重性远远超过任何有益作用,因此排除了单独使用炔雌醇甲醚对绝经后女性进行长期激素替代治疗的可能性。

引用本文的文献

1
Oestrogen replacement therapy for prevention of osteoporosis after oophorectomy.
Br Med J. 1973 Sep 8;3(5879):515-8. doi: 10.1136/bmj.3.5879.515.
2
Comparative trial of P1496, a new non-steroidal oestrogen analogue.
Br Med J. 1973 Mar 10;1(5853):579-81. doi: 10.1136/bmj.1.5853.579.
3
[Metabolic studies under administration of oral contraceptives. A review].
Z Ernahrungswiss. 1978 Mar;17(1):1-18. doi: 10.1007/BF02020687.

本文引用的文献

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A method for the determination of urinary pregnanediol.
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N Engl J Med. 1965 Feb 11;272:305-8. doi: 10.1056/NEJM196502112720608.
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JAMA. 1967 Sep 18;201(12):918-22. doi: 10.1001/jama.201.12.918.

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