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雌激素替代疗法对绝经后冠心病患者及正常妇女的影响 |
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黎映兰 谭宁
【摘要】 目的 观察雌激素治疗绝经后冠心病患者及正常妇女体内血脂、血小板聚集率、氧自由基及纤溶活性变化。方法 选53例绝经后妇女冠心病患者为冠心病组，42例绝经后健康妇女为正常对照组，每组病例再单盲随机分为治疗组和安慰剂组，治疗组予尼尔雌醇(每月4 mg/次)治疗6个月，安慰剂组予安慰剂治疗，观察治疗前后患者雌激素水平及血脂各项指标、血小板聚集率、氧自由基和纤溶活性变化。结果 冠心病组雌激素水平低于正常对照组(P＜0.01)；尼尔雌醇治疗后绝经后妇女的胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)、载脂蛋白B100(ApoB100)均降低(P＜0.05或P＜0.01)，高密度脂蛋白-胆固醇(HDL-C)、载脂蛋白A1(ApoA1)升高(P＜0.05)，血小板聚集率降低(P＜0.05)；丙二醛(MDA)、t-PA抑制物(PAI)下降(P＜0.05)，超氧化物歧化酶(SOD)、组织纤溶酶原激活物(t-PA)升高(P＜0.05或P＜0.01)。结论 雌激素对绝经后冠心病患者及正常妇女的心脏有保护作用，提示雌激素替代疗法可作为绝经后妇女防治冠心病的基本方法。
【关键词】 雌激素 替代疗法 绝经后 冠心病
Effects of estrogen replacement therapy in post-menopausal women with or without coronary artery disease
Li Yinglan
（Department of Endocrinology Guangdong Provincial Institute of Geriatrics）
Tan Ning
（Department of Cardiology, Guangdong Provincial Cardiovascular Institute, Guangzhou 510080）
【Abstract】 Objective To investigate the change of estrogen replacement therapy on lipids, platelet maximum agglomerate rate (PMAR), malondialdehyde (MDA), superoxide dismutase (SOD), tissue-type plasminogen activator(t-PA), tissuetype plasminogen activator inhibitor (PAI) in post-menopausal women with or without coronary artery disease (CAD). Methods Rando-mized placebo-controlled trial was conducted in fifty-three post-menopausal women with CAD and forty-two normal post-menopausal women by receiving nilestriol (4 mg for one time per month) replacement or placebo treatment for six months. Before and in the end of study, the serum levels of estradiol (E2), total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B100 (ApoB100) levels were assessed.Results E2 level in the CAD group was lower than that in the normal group (P＜0.01).After nilestriol treatment, the serum levels of TC, LDL-C, ApoB100, PMAR, MDA, PAI decreased (P＜0.05 or P＜0.01)and HDL-C, Apo A1,SOD, t[1] [2] 下一页
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