Estrogen use in postmenopausal women--costs, risks, and benefits.
Estrogen use in postmenopausal women--costs, risks, and benefits.
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绝经后妇女使用雌激素——成本、风险和收益。
DOI：
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发表时间：
1980
影响因子：
158.5
通讯作者：
M. Weinstein
中科院分区：
文献类型：
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作者：
M. Weinstein
使用来自医学和流行病学文献的数据分析绝经后妇女使用雌激素的成本效益。子宫内膜癌、子宫出血和胆囊疾病的风险与缓解更年期症状以及预防骨质疏松症和随之而来的骨折相关的益处进行了权衡。对预期寿命的净影响可能在两个方向上都很小，尽管它们在患有骨质疏松症或先前子宫切除术的妇女中可能是积极的。对于有子宫切除术或骨质疏松症病史的绝经期妇女，治疗似乎相对具有成本效益，但对于子宫完整的无症状妇女，作为预防性措施似乎不具有成本效益。对于有绝经期症状和子宫完整的妇女，为个体患者处方雌激素的决定和在社会水平上使用雌激素的成本效益主要取决于分配给症状缓解的主观价值。
The cost effectiveness of estrogen use in postmenopausal women was analyzed with use of data from the medical and epidemiologic literature. Risks of endometrial cancer, uterine bleeding, and gallbladder disease were weighed against benefits associated with relief of menopausal symptoms and with prevention of osteoporosis and consequent fractures. Net effects on life expectancy are probably small in either direction, although they are likely to be positive in women with existing osteoporosis or prior hysterectomy. Treatment appears to be relatively cost effective in menopausal women with prior hysterectomy or osteoporosis but does not appear to be cost effective as a prophylactiv measure in asymptomatic women with intact uteri. For women with menopausal symptoms and intact uteri, the decision to prescribe estrogens for the individual patient and the cost effectiveness of estrogen use at the societal level depend critically on the subjective values assigned to symptomatic relief.