45至89岁绝经后女性的雌激素替代疗法与尿路感染

Estrogen replacement therapy and urinary tract infections in postmenopausal women aged 45-89.

作者信息

Oliveria S A, Klein R A, Reed J I, Cirillo P A, Christos P J, Walker A M

机构信息

Strang Cancer Prevention Center, New York, New York 10021, USA.

出版信息

Menopause. 1998 Spring;5(1):4-8.

PMID:9689188

Abstract

OBJECTIVE

An elevated risk of urinary tract infections (UTIs) in postmenopausal women has been attributed to an increase in the vaginal pH. Estrogen replacement therapy (ERT) helps restore the vaginal milieu and may have a beneficial effect on risk of infection. Studies examining the association between ERT and UTIs have been inconsistent. We conducted a nested case control study to clarify this relationship in women aged 45-89.

DESIGN

For each case, we selected up to five control women, matched by year of birth. We used pharmacy records to classify women as new users, past users, ongoing users (past and new users), and never users of ERT. There were 254 cases and 1,268 controls.

RESULTS

The risk ratio for UTI was 1.02 [95% confidence interval (CI) 0.74, 1.40] for any use versus never use, after adjustment for health care utilization. The risk ratio for the association between new use and UTI was 1.13 (95% CI 0.46, 2.77). For ongoing users the risk ratio was 1.08 (95% CI 0.76, 1.54), whereas the risk ratio for past use was 0.77 (95% CI 0.39, 1.48).

CONCLUSIONS

Our results do not support a protective effect of ERT on the risk of UTIs.

摘要

目的

绝经后女性尿路感染（UTIs）风险升高归因于阴道pH值升高。雌激素替代疗法（ERT）有助于恢复阴道环境，可能对感染风险产生有益影响。关于ERT与UTIs之间关联的研究结果并不一致。我们进行了一项巢式病例对照研究，以阐明45至89岁女性中的这种关系。

设计

对于每例病例，我们选择多达五名对照女性，按出生年份进行匹配。我们使用药房记录将女性分为ERT新使用者、既往使用者、持续使用者（既往和新使用者）以及从未使用者。共有254例病例和1268名对照。

结果

在对医疗保健利用情况进行调整后，任何使用ERT与从未使用相比，UTI的风险比为1.02[95%置信区间（CI）0.74，1.40]。新使用与UTI之间关联的风险比为1.13（95%CI 0.46，2.77）。持续使用者的风险比为1.08（95%CI 0.76，1.54），而既往使用者的风险比为0.77（95%CI 0.39，1.48）。