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接受经皮雌激素与左炔诺孕酮宫内节育器联合治疗的绝经后妇女的血清脂质和脂蛋白

Serum lipids and lipoproteins in postmenopausal women receiving transdermal oestrogen in combination with a levonorgestrel-releasing intrauterine device.

作者信息

Raudaskoski T H, Tomás E I, Paakkari I A, Kauppila A J, Laatikainen T J

机构信息

Department of Obstetrics and Gynaecology, University of Oulu, Finland.

出版信息

Maturitas. 1995 Jun;22(1):47-53. doi: 10.1016/0378-5122(95)00906-2.

Abstract

OBJECTIVES

To compare the effects of a non-oral combination of a transdermal oestradiol patch (50 micrograms daily) and an intrauterine device (IUD) releasing 20 micrograms of levonorgestrel daily on the serum pattern of lipids and lipoproteins with an established oral regimen of a daily dose of 2 mg of estradiol and 1 mg of noretisterone acetate.

METHODS

An open, randomized study comprised of 40 healthy, early postmenopausal women.

RESULTS

During 1 year the concentration of total cholesterol decreased 5.0% in the LNg-IUD group and 10.6% in the oral therapy group; HDL cholesterol decreased 10.9% and 12.8%, respectively, and HDL2 cholesterol decreased 18.1% and 26.9%, respectively. LDL cholesterol values did not change in the LNg-IUD group, whereas a 10.3% decrease was observed in the oral therapy group. Triglyceride values did not change in either group. There were no significant differences in the serum lipoprotein changes between the groups during the treatment.

CONCLUSIONS

The use of a non-oral regimen of hormone replacement therapy has been advocated to minimize the effect of steroids on the liver. Its effects on the serum pattern of lipids and lipoproteins, however, did not differ significantly from those induced by a continuous oral treatment regimen.

摘要

目的

比较经皮雌二醇贴片(每日50微克)与每日释放20微克左炔诺孕酮的宫内节育器(IUD)的非口服联合用药方案,与已确立的每日剂量为2毫克雌二醇和1毫克醋酸炔诺酮的口服用药方案对血脂和脂蛋白血清模式的影响。

方法

一项开放性随机研究,纳入40名健康的绝经早期妇女。

结果

在1年期间,左炔诺孕酮宫内节育器(LNG-IUD)组总胆固醇浓度下降5.0%,口服治疗组下降10.6%;高密度脂蛋白(HDL)胆固醇分别下降10.9%和12.8%,HDL2胆固醇分别下降18.1%和26.9%。LNG-IUD组低密度脂蛋白(LDL)胆固醇值未变化,而口服治疗组观察到下降10.3%。两组甘油三酯值均未变化。治疗期间两组间血清脂蛋白变化无显著差异。

结论

已提倡采用非口服激素替代疗法方案以尽量减少类固醇对肝脏的影响。然而,其对血脂和脂蛋白血清模式的影响与持续口服治疗方案所引起的影响无显著差异。

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