Efficacy of a Continuous Estrogen‐Progestin Regimen in the Menopausal Patient
Efficacy of a Continuous Estrogen‐Progestin Regimen in the Menopausal Patient
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连续雌激素-孕激素治疗方案对绝经期患者的疗效
DOI：
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发表时间：
1987
影响因子：
7.2
通讯作者：
L. Weinstein
中科院分区：
文献类型：
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作者：
L. Weinstein
使用非对抗性雌激素的主要问题是其对子宫内膜的肿瘤作用。用于对抗雌激素的孕激素可能与阴道出血和逆转雌激素对血清脂蛋白浓度的保护性变化有关。在一项研究中，所有绝经后妇女均接受结合马雌激素 1-28 天；其中，I 组接受 2.5 mg 醋酸甲羟孕酮，持续 1-28 天；II 组接受 5 mg 醋酸甲羟孕酮，持续 1-28 天；III 组接受 5 mg 醋酸甲羟孕酮，持续 17-28 天。连续雌激素-孕激素联合治疗后，子宫内膜的用药前和用药后评估显示出现萎缩性变化。研究前和研究后血清脂蛋白浓度评估表明，I 组和 III 组中胆固醇和低密度脂蛋白胆固醇显着下降，而 II 组没有变化。所有患者每周写日记，记录任何阴道出血或血管舒缩症状的变化。结果表明，0.625 mg 结合马雌激素与 2.5 mg 醋酸甲羟孕酮的连续治疗方案作为绝经后患者的主要激素替代疗法是有益的。
The major concern with the use of unopposed estrogen is its neoplastic effect on the endometrium. Progestins used to oppose the estrogen may be associated with vaginal bleeding and reversal of estrogen's protective changes in serum lipoprotein concentrations. A study was performed in which all postmenopausal women received conjugated equine estrogen for days 1–28; with group I receiving 2.5 mg medroxyprogesterone acetate for days 1–28, group II receiving 5 mg medroxyprogesterone acetate for days 1–28, and group III receiving 5 mg medroxyprogesterone acetate for days 17–28. Pre- and postdrug evaluations of the endometrium revealed atrophic changes after therapy with continuous combined estrogen-progestin. Pre- and poststudy evaluation of serum lipoprotein concentrations demonstrated significant declines in cholesterol and low-density lipoprotein cholesterol within groups I and III, and no change in group II. All patients kept a weekly diary recording any vaginal bleeding or change in vasomotor symptoms. The results suggest that a continuous regimen of 0.625 mg conjugated equine estrogen with 2.5 mg medroxyprogesterone acetate is beneficial as a primary hormonal replacement therapy for the postmenopausal patient.