Achiron R, Lipitz S, Frenkel Y, Mashiach S
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Ultrasound Obstet Gynecol. 1995 Jun;5(6):411-4. doi: 10.1046/j.1469-0705.1995.05060411.x.
This study was conducted to evaluate endometrial blood flow characteristics in response to estrogen replacement therapy (ERT) and tamoxifen in asymptomatic postmenopausal women, and to correlate the resistance index (RI) with plasma estradiol levels. Transvaginal color Doppler ultrasound examinations were performed in 30 asymptomatic, postmenopausal women who demonstrated thin endometria (< 0.5 cm). Ten healthy women receiving ERT and ten women with breast cancer receiving tamoxifen comprised the study groups. Ten postmenopausal women free of any hormonal treatment comprised the control group. Blood flow response was assessed by visualization of arterial waveforms in the endometrial region. Resistance indices were calculated for analysis and correlated with peripheral blood levels of estradiol. All postmenopausal women treated with tamoxifen or ERT showed continuous forward end-diastolic flow velocities, while the menopausal women without treatment demonstrated partial forward end-diastolic flow. Resistance index values of non-treated women were invariably higher (mean 0.89, range 0.85-0.91) than in those on tamoxifen (mean 0.79, range 0.54-0.90; p < 0.05), while the lowest RI was obtained in women taking ERT (mean 0.66, range 0.54-0.90; p < 0.05). The plasma concentrations of estradiol in women on ERT were found to be significantly higher than those of the tamoxifen and control groups. The observed data suggest that ERT and tamoxifen modify normal postmenopausal endometrial perfusion. Tamoxifen had a weaker estrogenic effect on the endometrial blood flow resistance, and ERT enhanced endometrial blood perfusion through vasodilatation.
本研究旨在评估无症状绝经后妇女接受雌激素替代疗法（ERT）和他莫昔芬治疗时子宫内膜血流特征，并将阻力指数（RI）与血浆雌二醇水平进行关联。对30名无症状、绝经后且子宫内膜薄（<0.5 cm）的妇女进行经阴道彩色多普勒超声检查。10名接受ERT的健康妇女和10名接受他莫昔芬治疗的乳腺癌妇女组成研究组。10名未接受任何激素治疗的绝经后妇女组成对照组。通过观察子宫内膜区域的动脉波形来评估血流反应。计算阻力指数进行分析，并与外周血雌二醇水平进行关联。所有接受他莫昔芬或ERT治疗的绝经后妇女均显示舒张末期血流速度持续向前，而未治疗的绝经妇女表现为部分舒张末期血流向前。未治疗妇女的阻力指数值始终高于接受他莫昔芬治疗的妇女（平均0.89，范围0.85 - 0.91）（p<0.05），而接受ERT治疗的妇女阻力指数最低（平均0.66，范围0.54 - 0.90；p<0.05）。发现接受ERT治疗的妇女血浆雌二醇浓度显著高于他莫昔芬组和对照组。观察到的数据表明，ERT和他莫昔芬可改变绝经后子宫内膜的正常灌注。他莫昔芬对子宫内膜血流阻力的雌激素作用较弱，而ERT通过血管舒张增强子宫内膜血流灌注。
