Camilli A, Di Benedetto L, Camilli F M, Ermini M
II Istituto di Clinica Ostetrica e Ginecologica, Università degli Studi di Roma La Sapienza.
Minerva Ginecol. 1997 May;49(5):199-202.
During menopause the number of cardiovascular attacks increases parallel to the elimination of estradiol production. The administration of the latter reverses this tendency owing to a compound mechanism (improved HDL) cholesterol/total cholesterol ratio, diminished vasal resistance).
The authors present a study performed in 34 patients in menopause receiving oestroprogestinic replacement therapy using an oral or transdermal route. Metabolic status (serum concentrations of total cholesterol (TC) and HDL cholesterol (C.HDL) was evaluated in all patients before treatment and after 12 months.
A statistically significant positive correlation (p < 0.0001) was found between the use of oestrogen and serum levels of HDL. This correlation appeared to be more evident in patients using transdermal treatment compared to the oral form.
The authors conclude that in the absence of contraindications, hormone replacement therapy in menopause exercises a beneficial effect on the lipid status, contributing to diminishing the risk of cardiovascular attacks. The possibility of an increased incidence of breast cancer is now being evaluated, whereas effective protection of the endometrium against the risk of hyperplasia and cancer was shown using the doses of progestin used in this study, which coincide with those currently prescribed in the literature.
在更年期期间，心血管疾病发作的次数随着雌二醇分泌的减少而平行增加。补充雌二醇可通过复合机制（改善高密度脂蛋白胆固醇/总胆固醇比率、降低血管阻力）扭转这种趋势。
作者介绍了一项针对34名接受口服或经皮雌激素 - 孕激素替代疗法的更年期患者进行的研究。在治疗前和治疗12个月后对所有患者的代谢状况（总胆固醇（TC）和高密度脂蛋白胆固醇（C.HDL）的血清浓度）进行了评估。
发现雌激素的使用与高密度脂蛋白的血清水平之间存在统计学上显著的正相关（p < 0.0001）。与口服形式相比，这种相关性在使用经皮治疗的患者中似乎更明显。
作者得出结论，在没有禁忌症的情况下，更年期激素替代疗法对血脂状况有有益影响，有助于降低心血管疾病发作的风险。目前正在评估乳腺癌发病率增加的可能性，而使用本研究中所用的孕激素剂量可有效保护子宫内膜免受增生和癌症风险，这些剂量与目前文献中规定的剂量一致。
