経口および経皮エストロゲン置換療法と静脈性血栓塞栓症のリスクとの差異的な関連性
Pierre-Yves Scarabin1, Emmanuel Oger, Geneviève Plu-Bureau
1INSERM Cardiovascular Epidemiology Unit U258, Villejuif, France. scarabin@vjf.inserm.fr <scarabin@vjf.inserm.fr>
Lancet (London, England)
|August 21, 2003
まとめ
経口エストロゲン置換療法 (ERT) は,閉経後の女性の静脈血栓栓塞栓症 (VTE) のリスクを大幅に増加させます. トランスダーマルERTはVTEのリスクを高めず,より安全な代替案である可能性を示唆しています.
科学分野:
- 生殖医学は,生殖器医学である.
- 心血管の健康について
- 薬理学 薬理学とは
背景:
- 経口エストロゲン置換療法 (ERT) は,閉経後の女性の血液凝固と静脈血栓塞栓症 (VTE) のリスクを増加させることが知られている.
- トランスダーマルERTは,血液静止に最小限の影響を及ぼしますが,その血栓性リスクはまだ十分に研究されていません.
研究 の 目的:
- 閉経後の女性におけるVTEリスクに対する,経口および経皮ERT投与経路の差異的な効果を調査する.
主な方法:
- フランスでは1999年から2002年の間に,病院ベースの多センター症例対照研究が行われました.
- 異変性静脈栓塞症 (肺栓塞症または深静脈血栓症) を患った155人の閉経後の女性と381人のマッチングした対照群を募集しました.
主要な成果:
- 経口ERT使用者は,使用しない人と比較して,有意に高まったVTEリスク (OR3.5;95%CI1.8-6.8) を有していた.
- 経皮ERT使用者は,使用しない人と比較して,VTEリスクの増加 (OR 0.9; 95%CI 0.5-1.6) を示しませんでした.
- 経口ERT使用者は,経皮ERT使用者と比較して4倍高いVTEリスクに直面しました (OR 4.0; 95%CI 1.9-8.3).
結論:
- 経口ERTは,閉経後の女性のVTEのリスク増加と関連しています.
- トランスダーマルERTは,血栓形成のリスクに関して,より安全な代替案であるようです.
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