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目的:研究口服和经皮雌激素替代疗法(ERT)对手术绝经妇女围绝经症状、血脂和凝血功能的影响。方法:手术绝经妇女随机分为口服组和皮贴组,分别使用雌二醇(E2)口服片(1 mg/d)和雌二醇皮贴片(1.5 mg/周)3个月。用药前、后分别检测血中E2和卵泡刺激素(FSH)水平,评估围绝经症状和生存质量,测定血脂和凝血功能。结果:口服组和皮贴组用药后血清E2水平明显升高,FSH水平明显降低,围绝经症状和生存质量均得到明显改善,组间无统计学差异。口服组用药后三酰甘油(TG)、高密度脂蛋白(HDL)较治疗前显著上升,低密度脂蛋白(LDL)较治疗前显著降低;皮贴组用药后HDL较治疗前有升高趋势,但差异无统计学意义(P>0.05),LDL较治疗前显著降低(P<0.05)。口服组用药后活化部分凝血活酶时间(APTT)较治疗前显著降低,其余各凝血指标与治疗前比较均无统计学差异;皮贴组用药后各凝血指标均较治疗前无显著变化。结论:口服和经皮ERT均能改善手术绝经妇女的围绝经症状,但两者在血脂和凝血方面作用不同。
AIM: To investigate the effects of oral and transdermal estrogen replacement therapy (ERT) on postmenopausal symptoms, blood lipids and coagulation in postmenopausal women. Methods: Menopausal women undergoing surgery were randomly divided into oral and epidural groups. Estradiol (E2) tablets (1 mg / d) and estradiol patch (1.5 mg / week) were used for 3 months. The levels of E2 and follicle stimulating hormone (FSH) were measured before and after treatment. The menopausal symptoms and quality of life were evaluated. The blood lipids and coagulation were measured. Results: The levels of serum E2 and the level of FSH in oral and dermatological groups were significantly decreased, while the symptoms and quality of life in perimenopausal women were significantly improved. There was no significant difference between the two groups. After oral administration, triglyceride (TG) and high-density lipoprotein (HDL) increased significantly compared with those before treatment, and LDL decreased significantly compared with that before treatment; , But the difference was not statistically significant (P> 0.05), LDL was significantly lower than before treatment (P <0.05). After oral administration of activated partial thromboplastin time (APTT) was significantly lower than before treatment, the rest of the coagulation index compared with before treatment were no significant difference; skin paste group after the administration of coagulation indicators were no significant changes than before treatment. Conclusions Both oral and transdermal ERT can improve perimenopausal symptoms in surgical menopause women, but both have different effects on blood lipids and coagulation.