绝经期激素补充治疗对血清E2、血脂及子宫内膜的影响

目的观察不同绝经年限妇女激素补充治疗(HRT)对血清E2、血脂及子宫内膜的影响.方法对38例绝经1～5年和30例绝经5年以上妇女连续联合使用激素补充治疗半年,用药前后观察绝经期症状、血清E2、血脂四项、子宫内膜厚度及内膜细胞形态变化.结果用药后两组之绝经期症状均明显改善,Kupperman评分显著下降;用药后E2均显著升高(P<0.01),FSH显著下降(P<0.05);绝经1～5年组总胆固醇(CHOL)、甘油三酯(TG)、低密度脂蛋白(LDL)均显著下降,高密度脂蛋白(HDL)显著上升;而绝经5年以上组用药后CHOL、LDL有所下降,而TG、HDL有升高趋势,但差异无统计学意义.两组HRT后子宫内膜均较HRT前增厚,1～5年组以混合型及增殖期型比例为主,而5年以上组以萎缩型为主.内膜＞5mm者,1～5年组以增殖期型及伴分泌象为主,而5年以上组以增殖期型为主.1～5年组非计划性出血率高于5年以上组.结论不同绝经年限妇女使用激素补充治疗(HRT)均能显著改善绝经期症状,但在血脂代谢及对子宫内膜的影响上却存在差异,使用HRT时宜根据绝经年限、治疗目的选择用药.

The Influence of Human Supplementary Menopausal Hormonotherapy on Serum E2,Blood-lipid and Endometrium

Objective:The influence of human supplementary menopausal hormonotherapy on serum E2,blood-lipid and endometrium of the women of different ages was observed.Methods:38 cases of menopause from one to five years and 30 cases of menopause for more than five years were used human supplementary menopausal hormonotherapy for half a year.Before and after the administration,the climacteric symptom,serum E2,the depth of endometrium as well as the changes of cell shape in tunica intima were observed.Results:After the administration,the climacteric symptom of the above two groups had been obviously improved.The Kupperman evaluation had been obviously decreased.E2 was significantly raised ( P <0.01) and FSH was significantly decreased ( P <0.05).Conclusion:The use of supplementary menopausal hormonotherapy at different menopauses can significantly improve the climacteric symptom,but as far as blood-lipid metabolism and the influence on endometrium are concerned,there exist differences.The use of supplementary menopausal hormonotherapy should be used according to the time of menopause and the purpose of treatment.