Rosenson R S, Tangney C C, Mosca L J
Preventive Cardiology Center, Lipoprotein and Hemorheology Research Facility, Chicago, Ill, USA.
Arterioscler Thromb Vasc Biol. 1998 Dec;18(12):1902-5. doi: 10.1161/01.atv.18.12.1902.
Hormone replacement therapy may protect against cardiovascular disease through several mechanisms that have variable actions on the major determinants of plasma viscosity. Plasma viscosity is an important predictor of incident and recurrent cardiovascular events and mortality in coronary heart disease patients. The effect of estrogen alone or in combination with progestin on plasma viscosity is not known. Using a randomized, double-blind design, we examined the impact of the following daily hormone regimens on plasma viscosity in 23 women: (1) 1 mg estradiol and 2.5 mg medroxyprogesterone (n=7); (2) 1 mg estradiol alone (n=8); and (3) placebo (n=8). Plasma viscosity, fibrinogen, and standard lipoprotein levels were determined at baseline and after 12 weeks of intervention. Plasma viscosity was measured at 37 degreesC with a coaxial microviscometer. Fibrinogen was measured by the Clauss method. Significant changes in plasma viscosity (mPa.s) levels occurred among treatment groups (P<0.01) after the intervention. Plasma viscosity was significantly reduced with estrogen replacement therapy (P<0.01). These data demonstrate that estrogen replacement therapy lowers plasma viscosity. This study suggests an additional mechanism for the cardiovascular protection conferred to postmenopausal women on estrogen replacement therapy.
激素替代疗法可能通过多种机制预防心血管疾病，这些机制对血浆黏度的主要决定因素具有不同的作用。血浆黏度是冠心病患者发生心血管事件和复发以及死亡率的重要预测指标。单独使用雌激素或与孕激素联合使用对血浆黏度的影响尚不清楚。我们采用随机、双盲设计，研究了以下每日激素治疗方案对23名女性血浆黏度的影响：（1）1毫克雌二醇和2.5毫克甲羟孕酮（n = 7）；（2）仅1毫克雌二醇（n = 8）；（3）安慰剂（n = 8）。在基线和干预12周后测定血浆黏度、纤维蛋白原和标准脂蛋白水平。用同轴微粘度计在37℃下测量血浆黏度。用克劳斯法测量纤维蛋白原。干预后各治疗组血浆黏度（毫帕·秒）水平发生显著变化（P<0.01）。雌激素替代疗法可显著降低血浆黏度（P<0.01）。这些数据表明，雌激素替代疗法可降低血浆黏度。本研究提示了雌激素替代疗法赋予绝经后女性心血管保护作用的另一种机制。
