Munk-Jensen N, Ulrich L G, Obel E B, Nielsen S P, Edwards D, Meinertz H
Department of Obstetrics and Gynecology, Central Hospital, Hilleroed, Denmark.
Am J Obstet Gynecol. 1994 Jul;171(1):132-8. doi: 10.1016/0002-9378(94)90458-8.
Our purpose was to examine the effects of postmenopausal estrogen therapy supplemented with progestogen on plasma lipoprotein levels.
One hundred thirteen women were randomized to receive either placebo or a combination of 17 beta-estradiol and norethindrone acetate administered continuously (Kliogest) or sequentially (Trisequens). Plasma lipoprotein levels were measured at baseline and after 2 years of treatment and compared by analysis of variance.
Hormone therapy lowered plasma cholesterol levels (p < 0.001) and low-density lipoprotein cholesterol (Kiogest, p < 0.001; Trisequens, p < 0.01), whereas high-density lipoprotein cholesterol levels were unchanged (Trisequens) or reduced (Kliogest, p < 0.01), primarily because of a decrease in the high-density lipoprotein-2 subfraction (p < 0.05). Low-density lipoprotein/high-density lipoprotein cholesterol ratios remained unchanged.
Although hormonal replacement therapy with estradiol combined with norethindrone acetate eliminated the increase in high-density lipoprotein cholesterol levels observed with estrogen monotherapy, the reductions in low-density lipoprotein cholesterol concentrations still suggest reduced cardiovascular risk, according to the National Cholesterol Education Program and to recent observations indicating that risk is not necessarily inversely proportional to high-density lipoprotein cholesterol levels.
我们的目的是研究绝经后补充孕激素的雌激素疗法对血浆脂蛋白水平的影响。
113名女性被随机分为两组，分别接受安慰剂或连续服用（克龄蒙）或序贯服用（特居乐）17β-雌二醇与醋酸炔诺酮的组合药物。在基线时及治疗2年后测量血浆脂蛋白水平，并通过方差分析进行比较。
激素疗法降低了血浆胆固醇水平（p<0.001）和低密度脂蛋白胆固醇水平（克龄蒙，p<0.001；特居乐，p<0.01），而高密度脂蛋白胆固醇水平未改变（特居乐）或降低（克龄蒙，p<0.01），主要是由于高密度脂蛋白-2亚组分减少（p<0.05）。低密度脂蛋白/高密度脂蛋白胆固醇比值保持不变。
根据美国国家胆固醇教育计划以及最近的观察结果，即风险不一定与高密度脂蛋白胆固醇水平成反比，虽然雌激素联合醋酸炔诺酮的激素替代疗法消除了雌激素单一疗法中观察到的高密度脂蛋白胆固醇水平的升高，但低密度脂蛋白胆固醇浓度的降低仍表明心血管风险降低。
